The nurses and the unit manager have been involved in shared decision-making related to the model of nursing care delivery that the unit will adopt. All individuals have participated and been involved in decision-making and implementation of changes. When issues arise during implementation, it is expected that:

Individual expertise will be utilized to provide solutions, but responsibility for the change is shared.

This will contribute to widespread skepticism among the staff about the probability of success.

Accountability resides entirely with the unit manager.

No one really has any accountability or responsibility for the changes.

Answer and Explanation

The Correct Answer is A

Choice A reason: Utilizing individual expertise while sharing responsibility ensures that all team members are involved in problem-solving and that no single person is burdened with the outcome. This approach aligns with the principles of shared decision-making, which emphasize collaboration and collective accountability.

Choice B reason: Shared decision-making aims to reduce skepticism by involving staff in the decision-making process, thereby increasing buy-in and the likelihood of success. Widespread skepticism would suggest a failure in the decision-making process.

Choice C reason: In a shared decision-making model, accountability does not rest solely with the unit manager. Instead, it is distributed among all individuals involved in the decision-making process.

Choice D reason: The statement that no one has any accountability or responsibility for the changes is incorrect. Shared decision-making requires that all participants take responsibility for the decisions made and their outcomes.

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Correct Answer is C

Explanation

Choice A reason: Hiring nurses who are not part of the union during a strike may be a strategic decision during labor disputes and does not necessarily constitute a situation warranting whistleblowing.

Choice B reason: Disregarding due process when disciplining a nurse can lead to unfair treatment and legal issues, making it a valid concern for whistleblowing to ensure justice and adherence to policies.

Choice C reason: Delaying responses to provide safe care compromises patient safety and could be a systemic issue that requires whistleblowing to bring attention to and rectify the situation.

Choice D reason: Refusing to bargain in good faith with the elected bargaining agent can disrupt labor relations and may be a serious concern, but it typically involves legal and union intervention before whistleblowing is considered.

A. Ask Nurse A to explain her position regarding prostate cancer patients and seek alternatives to prevent future issues. B. Allow them this flexibility: as long as the patient is well cared for, it doesn't matter if the assignments are changed. C. Insist that they switch back to the original patient assignments and talk to each of them at the end of the shift. D. Explain to Nurse A and B that all patients deserve kindness and care regardless of their condition or the nurses' personal feelings.

Correct Answer is D

Explanation

Choice A reason: Asking Nurse A to explain her position is important for understanding her concerns. However, it does not immediately address the issue of equitable patient care, which is the priority.

Choice B reason: While flexibility can be important, allowing personal preferences to dictate patient assignments can lead to a slippery slope of discriminatory practices. Patient care should not be compromised by personal biases.

Choice C reason: Insisting on switching back to the original assignments without addressing the underlying issue may not resolve the conflict or lead to better patient care in the long term.

Choice D reason: This is the most appropriate first action as it addresses the core principle of nursing care — providing compassionate care to all patients. It sets a standard for professional behavior and ensures that personal feelings do not interfere with patient care.

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Naxlex Comprehensive Predictor Exams

The ED staff members are concerned that working long hours without rest puts patient safety at risk. One staff member decides that she will risk her job and become a whistleblower. Whistleblowing is an appropriate recourse when management:

Correct Answer is C

Explanation

You are the charge nurse. Two hours into the shift, you discover that two nurses (Nurse A and Nurse B) have switched patients because Nurse A does not like to take care of patients with prostate cancer. Which action should you take first?

Correct Answer is D

Explanation

A mediator suggested that the nurse manager and staff members decide on a method to resolve conflicts. It is important to have agreements about how team members will work together because:

A nurse intervenes when a client attempts to harm herself on the unit. During the interaction, the client slaps the nurse across the face, as a manager, it is important that you:

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Two employees disagree about who should work on Christmas Day. The bottom line is that one will have to work the first half of the shift and the other the second half. What is the best method for the manager to decide who will work each half?

A nurse manager is aware that which of the following is an internal factor that impacts staffing?

In determining the fit of a candidate with the culture of your unit, which of the following interview questions might be asked?

A leader guides people towards a common goal and, in addition, the leader should:

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