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As a new nurse manager who has 'inherited' a unit with high nurse turnover and complaints of patient dissatisfaction, your first course of action would be to:
- A. Determine levels of nurse engagement on the unit
- B. Review the personnel files of nurses who have resigned
- C. Interview upper management about their vision for the unit
- D. Meet with your staff to clarify your vision for the unit
Correct Answer: A
Rationale: High turnover and patient dissatisfaction often stem from low nurse engagement disconnection from work or leadership impacting care quality. As a new manager, assessing engagement through observation, surveys, or discussions reveals root causes, like poor morale or autonomy, guiding targeted improvements. Reviewing files offers historical data but not current dynamics. Interviewing management or sharing your vision comes later understanding staff engagement first grounds your strategy in the unit's reality. Studies (e.g., Aiken) show engaged nurses improve outcomes and retention, making this the critical starting point to address both issues effectively.
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Stephanie delegates effectively if she has authority to act, which is BEST defined as:
- A. Having responsibility to direct others
- B. Being accountable to the organization
- C. Having legitimate right to act
- D. Telling others what to do
Correct Answer: C
Rationale: Authority, for Stephanie, is the legitimate right to act sanctioned power to delegate beyond just directing, accountability, or ordering. In her role, this means assigning orientation tasks with official backing, ensuring compliance. Leadership hinges on this, balancing responsibility with power in a hospital where clear authority prevents chaos, enabling her to guide new nurses effectively toward patient care goals within her educational mandate.
When your text says that interpersonal communication can be thought of as a constellation of behaviours, it means that
- A. It is important to understand the joint actions people perform when they are together
- B. It is important to understand how people label and evaluate relationships
- C. It is important to understand the opposing forces that pull communicators in different directions
- D. None of the above; interpersonal communication is not a constellation of behaviours
Correct Answer: A
Rationale: Constellation means joint actions not labels, forces, or denial. Nurse leaders like team talks see this, contrasting with isolation. In healthcare, it's collaborative, aligning leadership with interaction.
The nurse is working with a group of students who are learning a high-risk procedure. How should the nurse best ensure learning while protecting the safety of clients?
- A. Create an unfolding case study featuring the procedure
- B. Use simulation for the students to practice the skill
- C. Help the students use a decision-making model to choose the safest technique
- D. Teach the students about the traditional problem-solving process before they practice the procedure
Correct Answer: B
Rationale: Simulation lets students master a high-risk procedure like intubation safely, unlike case studies, decision models, or problem-solving lessons. In nursing, hands-on practice in a controlled setting minimizes patient risk while building skill confidence. Case studies inform, models guide choices, and problem-solving teaches theory none replace real-time rehearsal. Leadership prioritizes this, ensuring novices like these students refine techniques (e.g., catheter insertion) without harm, safeguarding care quality in clinical training environments effectively.
The nurse is assessing a client with suspected hyperglycemia. Which finding supports this diagnosis?
- A. Polyuria
- B. Sweating
- C. Muscle cramps
- D. Shakiness
Correct Answer: A
Rationale: In suspected hyperglycemia, polyuria supports it, not sweating, cramps, or shakiness (hypoglycemia signs). High glucose spills into urine frequent urination signals control issues, unlike adrenergic responses. Leadership notes this imagine thirst; it guides insulin, aligning with diabetes care effectively.
A nurse manager is implementing a team nursing approach on his unit, hiring licensed practical nurses (LPNs) and assistive personnel (AP) as additional staff. Which of the following actions should the nurse manager take to facilitate acceptance of this change?
- A. Introduce the new approach and facilitate the development of a task force to plan implementation
- B. Announce the change and expect immediate compliance
- C. Train only the new staff on the approach
- D. Leave the staff to adapt on their own
Correct Answer: A
Rationale: Implementing a team nursing approach requires staff buy-in to ensure smooth adoption and effective collaboration. Introducing the new approach and creating a task force to plan its implementation actively involves the existing staff, giving them a sense of ownership and control over the change process. This strategy fosters acceptance by addressing concerns, encouraging input, and building a collaborative environment, which is critical in healthcare settings where teamwork directly impacts patient outcomes. Simply announcing the change without engagement risks resistance, as staff may feel blindsided or undervalued. Training only new staff excludes current employees, potentially creating resentment or confusion, while leaving staff to adapt independently neglects the need for structured guidance. Involving staff in planning leverages their expertise, reduces anxiety about the unknown, and aligns with leadership principles that prioritize communication and inclusion, ultimately enhancing the transition to a team-based model.