Nursing Elites

1. A client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?

• A. Continuous quality improvement
• B. Total quality management
• C. Six Sigma
• D. Quality management

Correct answer: B

Rationale: Total Quality Management (TQM) emphasizes meeting customer needs and satisfaction. In this scenario, by honoring the client's request to delay care to allow for rest, the nurse is aligning with the customer-focused approach of TQM. TQM seeks to continuously improve processes and services to enhance customer experiences and outcomes. Continuous Quality Improvement focuses on incremental improvements in processes and outcomes over time. Six Sigma is a data-driven approach to process improvement that aims to reduce defects and errors. Quality Management is a broader concept that encompasses various strategies to ensure quality standards are met.

2. The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?

• A. Give the patient 4 to 6 oz more orange juice.
• B. Administer the PRN glucagon (Glucagon) 1 mg IM.
• C. Have the patient eat some peanut butter with crackers.
• D. Notify the healthcare provider about the hypoglycemia.

Correct answer: A

Rationale: The correct action for the nurse to take next is to give the patient 4 to 6 oz more orange juice. The patient's blood glucose has increased from 62 mg/dL to 67 mg/dL after consuming the initial 4 oz of orange juice, indicating that the treatment is effective. Providing additional orange juice will help further raise the blood glucose levels. Administering glucagon (Choice B) is not necessary as the patient's blood glucose is already rising. Having the patient eat peanut butter with crackers (Choice C) is a slower-acting option compared to orange juice. Notifying the healthcare provider about the hypoglycemia (Choice D) is not needed at this point since the patient's blood glucose is improving.

3. What is the focus of a continuous quality improvement program?

• A. Family
• B. Client
• C. Nurse
• D. Physician

Correct answer: B

Rationale: The correct answer is B: Client. Continuous quality improvement programs are primarily focused on improving services and outcomes for clients or patients. While families, nurses, and physicians are essential in healthcare, in the context of quality improvement, the main focus is on enhancing the experience and results for the clients receiving care. Choices A, C, and D are incorrect because they do not align with the primary goal of a continuous quality improvement program, which is to enhance client satisfaction, safety, and outcomes.

4. When preparing for a meeting to discuss the annual budget, what would be the best approach to ensure all relevant points are covered?

• A. Prepare an agenda
• B. Use visual aids
• C. Invite only key stakeholders
• D. Review previous budgets

Correct answer: A

Rationale: Preparing an agenda is the best approach when discussing the annual budget to ensure that all relevant points are covered. An agenda helps structure the meeting, outline key topics, allocate time efficiently, and keep the discussion focused on important budget-related matters. It also assists in setting clear objectives and expectations for the meeting participants, ensuring that all necessary points are addressed and that the meeting stays on track. While using visual aids, inviting only key stakeholders, and reviewing previous budgets can be important steps in the budget discussion process, none of these can replace the crucial role of having a well-prepared agenda.

5. A nurse manager is preparing to review medication documentation with a group of newly licensed nurses. Which of the following statements should the nurse manager plan to include in the teaching?

• A. Use the complete name of the medication magnesium sulfate.
• B. Delete the space between the numerical dose and the unit of measure.
• C. Use the abbreviation SC when indicating a subcutaneous injection.
• D. Write the letter U when noting the dosage of insulin.

Correct answer: C

Rationale: The correct statement that the nurse manager should include in the teaching session is to use the abbreviation SC when indicating a subcutaneous injection. This is important for accurate and standardized medication documentation. Choice A is incorrect because using the complete name of medications is not always necessary and may lead to errors. Choice B is incorrect as spaces between dose and unit of measure are required for clarity and to avoid misinterpretation. Choice D is incorrect because the standard abbreviation for units should be used instead of the letter U to prevent confusion.

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