Nursing Elites

1. As a new graduate employed in a high-volume maternity unit that uses differentiated practice as its staffing model, what can the nurse expect?

• A. Evidence-based practice guides risk management principles.
• B. Client teaching is the responsibility of the team leader.
• C. The initial level of practice responsibility will be limited.
• D. Seniority is the main determinant of client assignments.

Correct answer: C

Rationale: In a differentiated practice model, the scope of nursing practice and responsibility are tailored to different levels of experience. As a new graduate with limited experience, the nurse can expect that the initial level of practice responsibility will be limited to match their skill level and knowledge. This allows for a gradual increase in responsibilities as the nurse gains more experience and expertise. Choice A is incorrect because evidence-based practice is related to clinical decision-making, not the staffing model. Choice B is incorrect as client teaching is typically a shared responsibility among the healthcare team, not solely the team leader's. Choice D is incorrect as differentiated practice models focus on skill level and competence rather than seniority when determining client assignments.

2. The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose

• A. washes the puncture site using warm water and soap
• B. chooses a puncture site in the center of the finger pad
• C. hangs the arm down for a minute before puncturing the site
• D. says the result of 120 mg indicates good blood sugar control

Correct answer: B

Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad is not recommended for blood glucose monitoring. The recommended sites are the sides of the fingertips. Option A is correct as washing the puncture site using warm water and soap is a good practice. Option C is also correct as hanging the arm down for a minute can help increase blood flow. Option D is incorrect as a blood sugar level of 120 mg/dL may not necessarily indicate good blood sugar control and needs further interpretation.

3. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision makers involved. Which step best describes the current stage the RN is working through?

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

Correct answer: C

Rationale: The correct answer is C: Planning. In the planning phase of addressing an ethical dilemma, the goals of treatment are established, decision makers are identified, and all available options are reviewed. The assessment phase involves collecting data and information, the diagnosis phase involves analyzing the information to identify the problem, and the implementation phase involves carrying out the chosen plan of action. Therefore, in this scenario, where decision makers are being identified, the RN is in the planning stage.

4. Which of the following best describes the role of a clinical nurse specialist (CNS)?

• A. Direct patient care provider
• B. Administrator of healthcare facilities
• C. Consultant for nursing staff
• D. Policy maker in healthcare organizations

Correct answer: C

Rationale: The correct answer is C. A clinical nurse specialist (CNS) serves as a consultant for nursing staff, providing expert advice and guidance on clinical practice. Choice A, 'Direct patient care provider,' is incorrect as CNS typically focus more on education, research, and consultation rather than direct patient care. Choice B, 'Administrator of healthcare facilities,' is incorrect as this role is usually fulfilled by nurse administrators or nurse managers. Choice D, 'Policy maker in healthcare organizations,' is incorrect as policy-making roles are typically held by individuals in healthcare administration or government positions.

5. When a Nurse Manager leaves the facility, and one of the remaining managers is given that assignment in addition to her current load without the open position being filled, this is an example of which of the following?

• A. Job enlargement
• B. Proactive management
• C. Time log
• D. Prioritizing

Correct answer: A

Rationale: The correct answer is A, job enlargement. Job enlargement involves adding more tasks to a job without changing the level of skill required. In this scenario, the manager is given additional responsibilities without the position being filled, resulting in combining positions and increasing the number of employees to supervise. Choice B, proactive management, is incorrect as it does not relate to the situation described. Choice C, time log, is not relevant to the scenario. Choice D, prioritizing, is also incorrect as it does not reflect the concept of combining positions and increasing supervisory responsibilities.

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