NR-446 Collaborative Healthcare - Set 3 - Part 3

Correct Answer: Intrapersonal conflict within the nurse

Intrapersonal conflict occurs within one person when internal values and obligations compete. The nurse knows what she believes is right but is constrained from acting on it, which is the classic picture of moral distress. Option b is incorrect because interpersonal conflict requires open discord between two or more people. The nurse has not confronted the family or the provider; the struggle is being carried privately. Option c is incorrect because intragroup conflict splits one team, as when a committee cannot agree on a policy draft. No colleagues on this unit are described as disagreeing with one another. Option d is incorrect because intergroup conflict sets two departments or two shifts against each other, such as the emergency department and an inpatient unit. Only a single nurse is in distress here.

Correct Answer: The clinically strong nurse who volunteered willingly

Clinical expertise is necessary but not sufficient; willingness is the other requirement, because a conscripted preceptor is a poor one. A competent nurse who volunteers can teach, model practice and give the orientee honest feedback. Option a is incorrect because years of practice do not make a teacher, and an unwilling preceptor transmits that resentment to the orientee. Precepting against one's will produces poor feedback and early turnover. Option b is incorrect because a nurse still consolidating her own role lacks the pattern recognition needed to explain reasoning. Assigning her sets up two struggling nurses instead of one supported one. Option c is incorrect because consistency is the single most important structural feature of orientation. A nurse who appears on the unit intermittently cannot follow the orientee's progression or be accountable for the competencies.

Correct Answer: I have carried the heaviest load three days and need relief.

An assertive statement names the specific situation factually and states a clear need without attacking the other person. This response owns the concern, gives the charge nurse the facts, and asks for something concrete. Option a is incorrect because minimizing the workload and agreeing to absorb it is the passive pattern the preceptor is trying to correct. The charge nurse learns nothing and the pattern repeats tomorrow. Option c is incorrect because accusing the charge nurse of not caring attacks character rather than describing behavior. Aggressive language may win the argument tonight but costs the working relationship the nurse still needs. Option d is incorrect because blanket agreement with whatever the unit needs surrenders the nurse's position entirely. Nothing in the sentence tells the charge nurse that the assignment pattern has become a problem.

Correct Answer: Thank the graduate and ask what happened

Psychological safety is built by responding to bad news with appreciation before anything else. Thanking the nurse who came forward and asking what happened tells the unit that speaking up is answered with curiosity rather than blame. Option b is incorrect because a quota produces filed forms rather than honest reports. Counting reports without changing what happens to the reporter measures compliance and leaves the fear that stopped the graduate exactly where it was. Option c is incorrect because staff already know the policy; the graduate withheld the near miss for fear of blame, not for want of instructions. A posted document changes nothing about how the first report is received. Option d is incorrect because framing reporting as an obligation adds pressure to a unit that is already afraid. Obligation raises the cost of the honest disclosure the manager needs, and quiet nurses simply stay quiet.

Correct Answer: Compromising, because each nurse gave something up

Compromising is moderate on both assertiveness and cooperativeness, and its defining feature is that each party gives something up. Both nurses got part of what they wanted and neither is fully satisfied. Option a is incorrect because collaboration ends with both parties fully satisfied through a new option neither had considered. Reluctant acceptance of an alternating turn is the signature of a divided outcome. Option b is incorrect because avoiding means refusing to face the conflict at all, through postponement or withdrawal. These nurses talked it through and reached a workable agreement about the conference. Option d is incorrect because accommodating requires one nurse to sacrifice entirely so the other gains everything. Here each nurse attends in alternate years, so no one absorbed the whole loss.

Correct Answer: Groupthink driven by pressure to agree

Groupthink is the loss of judgment when a cohesive group's drive for unanimity overrides realistic appraisal. Rapid agreement, direct pressure on the dissenter, and an illusion of unanimity are its classic warning signs. Option a is incorrect because lateral violence is hostile or harmful conduct between peers, such as sabotage, exclusion, or public humiliation. Shutting down a comment to preserve consensus is a decision-making failure, not an act of aggression. Option b is incorrect because a storming group argues openly and competes for influence. This council did the reverse: it reached instant agreement and treated a single objection as an obstacle to be removed. Option c is incorrect because role ambiguity means members do not know who is responsible for what, so tasks are dropped or duplicated. The council here knew its task and simply refused to examine it.

Correct Answer: Assign the chair role with authority and support

A stretch assignment develops a competent nurse when the authority is delegated with the task and support is scheduled rather than substituted. Chairing a real committee is meaningful work with recoverable risk, which is what growth requires. Option b is incorrect because watching for a year postpones the learning that only doing produces. A nurse at the competent stage is ready to lead a small project now, not to sit as an audience. Option c is incorrect because taking minutes is administrative support, not development. Under-delegation of meaningful work is itself a recognized error, and it blocks growth while the manager stays the only person who can lead. Option d is incorrect because responsibility handed over without authority is a trap rather than an opportunity. Pre-approving every decision tells the committee and the nurse that she is not really the chair.

Correct Answer: Direct the team to follow the leader's order

An emergency calls for the competing or directing mode. Time pressure and a designated leader make collaboration dangerous, so the team follows the direction now and the second nurse raises her concern at the debriefing afterward. Option a is incorrect because collaboration takes time a client in cardiac arrest does not have. Stopping resuscitation to explore two viewpoints would delay the drug and worsen the outcome. Option c is incorrect because splitting the difference is compromising, which fits equal power and moderate stakes. Resuscitation follows an evidence-based algorithm, and a midpoint between two drug sequences is not a clinical strategy. Option d is incorrect because handing the matter to a manager postpones a decision that must be made in seconds. Escalation belongs to problems that survive the resuscitation, not to the resuscitation itself.

Correct Answer: Apply an acuity tool the staff can verify

Workload inequity is a structural source of conflict, and the fix is an objective, transparent assignment method. An acuity tool that staff can check for themselves removes the perception of favoritism before resentment forms. Option a is incorrect because seniority is not a measure of how much care a client requires. Rotating by tenure substitutes one arbitrary rule for another and leaves the workload question unanswered. Option b is incorrect because self-selection lets the most assertive nurses take the lightest loads first. What began as grumbling would harden into open resentment once the pattern becomes visible to everyone. Option d is incorrect because preference-based assignment is exactly the practice the staff already suspect. Morale built on favoritism is fragile, and it collapses the moment one nurse compares her load with another's.

Correct Answer: Movement, because the plan is being implemented

Movement is where the plan is developed and carried out, including setting goals and target dates, involving everyone affected, piloting, supporting staff, evaluating and modifying. The unfreezing work ended when staff accepted the rates were unacceptable. Option a is incorrect because unfreezing ends once the group perceives the need for change. The stem opens by stating that staff already agreed the rates were unacceptable, so that work is behind them. Option b is incorrect because refreezing follows implementation and anchors the practice through policy, orientation, competency and audit. A trial that is still being adjusted has not yet become the unit's settled way of working. Option c is incorrect because confirmation belongs to Rogers' innovation-decision process, describing an individual seeking reinforcement after adopting. Lewin has three stages, and none of them carries that name.