During a team meeting, a head nurse (the superior) and a staff nurse (the subordinate) are having a disagreement over the unit's dressing change procedure. The staff nurse wishes to use a new procedure based on newly released nursing research. The head nurse disagrees. The head nurse later makes comments to other staff members questioning the credibility of the staff nurse. This behavior is associated with:

horizontal violence.

bullying

confrontation.

mediation.

Answer and Explanation

The Correct Answer is B

A.   Horizontal violence, also known as lateral violence, refers to aggressive or disruptive behavior between colleagues at the same level, such as between nurses. Since the head nurse is in a superior position and the staff nurse is a subordinate, the behavior described does not fit the definition of horizontal violence.
B.   Bullying involves repeated, intentional actions that undermine or belittle another person. The head nurse’s comments about the staff nurse’s credibility to other staff members could be considered a form of bullying, especially if this behavior is persistent and aims to undermine the staff nurse’s professional reputation or confidence.
C.   Confrontation is a direct approach to addressing disagreements or conflicts between individuals. It involves discussing differing views openly and is intended to resolve issues through dialogue. In this
case, the head nurse’s behavior does not involve direct confrontation with the staff nurse about the disagreement but rather involves undermining the staff nurse's credibility behind their back.
D.   Mediation is a process where a neutral third party helps facilitate communication and negotiation between conflicting parties to reach a resolution. The behavior described does not involve mediation; instead, it involves negative comments and undermining behavior without seeking resolution or involving a mediator.

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Correct Answer is C

Explanation

A. While it's possible that a worsening health state could contribute to non-adherence, it's unlikely to be the sole factor, especially given that the patient has been explained the medication regimen multiple times.
B. While motivation is important for adherence, it's also unlikely to be the sole factor. Many patients with chronic conditions experience challenges with motivation, but effective education and support can help address this.

C. This is the most likely explanation for the patient's repeated non-adherence to the medication regimen. Health literacy refers to an individual's ability to understand and use health information to make informed decisions.
D. This is a possibility, but it's important to rule out other factors first. Cognitive impairment would likely manifest in other areas of the patient's life as well, and it's important to conduct a thorough assessment to determine if this is the case.

A. The nurse waits for the patient to leave, then files an incident report. B. The nurse contacts the patient's next-of-kin on the telephone. C. The nurse walks with the patient, attempting to explain the risks of leaving against medical advice. D. The nurse calls security personnel to apprehend the patient.

Correct Answer is C

Explanation

A. Waiting for the patient to leave before filing an incident report is not the most appropriate response. The immediate priority should be addressing the situation to ensure the patient's safety and attempting to resolve any issues before the patient leaves.
B. Contacting the patient’s next-of-kin can be appropriate if the nurse is concerned about the patient’s safety and if it’s necessary to inform the family about the patient’s condition or situation. However, this should be done only after attempting to address the situation directly with the patient, if feasible. It’s important to first try to resolve the issue directly with the patient before involving family members.
C. Walking with the patient and explaining the risks of leaving against medical advice (AMA) shows a proactive approach to addressing the patient's concerns and ensuring they understand the potential consequences of their actions. This approach aims to de-escalate the situation, provide important information, and potentially encourage the patient to stay for necessary care.
D. Calling security personnel should be a last resort and is generally used in situations where there is a safety threat or risk of harm. In this case, the patient is leaving in a disgruntled state but not exhibiting violent or threatening behavior.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

After arguing with a nurse, a disgruntled patient removes their peripheral venous catheter, gathers their belongings, and storms out of the room. Which of the following actions made by the nurse is most appropriate?

Correct Answer is C

Explanation

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