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. Which of the following is an example of a sentinel event in healthcare?

• A. A patient falling in the hospital without injury
• B. A near-miss medication error
• C. An unexpected patient death unrelated to the natural course of illness
• D. A patient developing an infection during a hospital stay

Correct answer: C

Rationale: The correct answer is C. A sentinel event in healthcare is an unexpected patient death unrelated to the natural course of illness. These events are serious occurrences that warrant immediate investigation and response to prevent their recurrence and ensure patient safety. Choices A, B, and D do not fit the definition of a sentinel event. While choices A, B, and D are serious incidents, they do not involve an unexpected patient death unrelated to the natural course of illness, which is the defining characteristic of a sentinel event.

3. A nurse has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?

• A. The client reports relief of nausea.
• B. The tube aspirate has a pH less than 5.
• C. Bowel sounds are present on auscultation.
• D. An x-ray shows the end of the tube above the pylorus.

Correct answer: A

Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.

4. Which of the following is considered voluntary turnover?

• A. Desire to leave
• B. Termination
• C. Forced resignation
• D. Floating

Correct answer: A

Rationale: The correct answer is A, 'Desire to leave.' Voluntary turnover occurs when an employee chooses to leave the organization. In this case, it is a direct function of the nurse's desire to leave. Termination and forced resignation are involuntary processes where the decision is made by the employer, not the employee. 'Floating' refers to the reassignment of a nurse to a unit different from their usual work unit and is not directly related to turnover.

5. What is the primary purpose of a nurse staffing committee?

• A. To oversee patient safety initiatives
• B. To develop staffing policies and procedures
• C. To coordinate patient care
• D. To manage nurse recruitment

Correct answer: B

Rationale: The primary purpose of a nurse staffing committee is to develop staffing policies and procedures to ensure adequate nurse-to-patient ratios. By establishing these guidelines, the committee aims to optimize patient care by ensuring appropriate staffing levels, which in turn can enhance patient safety and coordination of care. While overseeing patient safety initiatives and managing nurse recruitment are important aspects of healthcare management, the core function of a nurse staffing committee is to create and implement policies that govern the allocation and distribution of nursing staff to meet patient care needs effectively. Therefore, choices A, C, and D, though relevant to healthcare, do not align with the primary purpose of a nurse staffing committee as outlined in the question.

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