Nursing Elites

1. The charge nurse role has negatively affected your relationship with your friends and made you feel tense and isolated. You decide that you will delegate more time-consuming tasks to staff who are not your friends, who then complain to your nurse manager about your perceived unfairness. You decide to:

• A. Talk with your friends individually to let them know that you will be assigning patients to all staff in an equitable manner.
• B. Not express your angry feelings.
• C. Talk about staff who are annoying you with staff on other units.
• D. Ignore your feelings of uncertainty, hoping they will diminish.

Correct answer: A

Rationale: In this scenario, it is essential to address the perceived unfairness in task delegation. Talking with your friends individually to explain that patients will be assigned equitably is the most appropriate course of action. This approach promotes transparency and fairness in task allocation, helping to maintain professional relationships. Choices B, C, and D are not suitable responses. Choice B ignores the issue, choice C involves unprofessional behavior by gossiping about colleagues, and choice D neglects addressing the root cause of the problem.

2. The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select all that apply.)

• A. Expected length of stay
• B. Assigned healthcare team
• C. Patient outcomes
• D. Medical history

Correct answer: C

Rationale: In developing a critical pathway for congestive heart failure (CHF), it is essential to include patient outcomes. Patient outcomes help guide the care plan and ensure that interventions are effective. The expected length of stay is crucial to plan for resources but is not directly related to the critical pathway components. While the assigned healthcare team is important for care delivery, it is not a standard component of a critical pathway. Medical history is valuable for understanding the patient's background but is not a core component of a critical pathway.

3. A client who had a stroke resulting in aphasia and dysphagia needs assistance. Which of the following tasks should the nurse assign to an assistive personnel (AP)?

• A. Assist the client with a partial bed bath.
• B. Measure the client's BP after the nurse administers an antihypertensive medication.
• C. Test the client's swallowing ability by providing thickened liquids.
• D. Use a communication board to ask what the client wants for lunch.

Correct answer: A

Rationale: The correct answer is A because assisting the client with a partial bed bath is within the scope of practice for an assistive personnel and does not require specialized medical knowledge. Choice B involves measuring BP, which requires specific training and assessment skills that an assistive personnel may not have. Choice C involves testing swallowing ability, which should be done by a healthcare provider due to the risks involved in dysphagia. Choice D involves communication, which is crucial but should be done by someone with training in managing aphasia to ensure effective communication with the client.

4. An RN�s current patient and family have presented her with an ethical dilemma. What is the first step the RN should take to find a workable solution to the problem?

• A. Planning
• B. Assessment
• C. Evaluation
• D. Implementation

Correct answer: B

Rationale: The first step is assessment and identification of the problem.

5. Which of the following is a key component of patient-centered care?

• A. Provider-centered decision making
• B. Timely discharge
• C. Respect for patient preferences
• D. Focusing on clinical outcomes

Correct answer: C

Rationale: The correct answer is C: Respect for patient preferences. Patient-centered care focuses on involving patients in their care decisions and respecting their preferences. Choice A, provider-centered decision making, goes against the concept of patient-centered care as it prioritizes the provider over the patient. Timely discharge, choice B, is important but not a defining component of patient-centered care. Focusing on clinical outcomes, choice D, is essential in healthcare but does not solely represent patient-centered care, which is more about personalized care and involving patients in decision-making.

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