Nursing Elites

1. A nurse is admitting a client who has an abdominal wound with a large amount of purulent drainage. Which of the following types of transmission precautions should the nurse initiate?

• A. Droplet precautions
• B. Protective environment
• C. Airborne precautions
• D. Contact precautions

Correct answer: D

Rationale: The correct answer is D: Contact precautions. Contact precautions are used when there is a risk of transmission of infections through direct or indirect contact. In this scenario, the client has an abdominal wound with purulent drainage, indicating a potential for infection transmission through contact. Droplet precautions (choice A) are used for infections transmitted through respiratory droplets, such as influenza. Protective environment (choice B) is used for immunocompromised clients. Airborne precautions (choice C) are used for infections transmitted through small droplets that remain in the air, like tuberculosis. Therefore, in this case, the nurse should initiate contact precautions to prevent the spread of infection.

2. When a policy violation occurs, what are the necessary steps for the nurse manager? (EXCEPT)

• A. Describing the staff nurse's behavior that violated the policy
• B. Terminating the staff immediately
• C. Confrontation
• D. Determining the employee's awareness of the policy

Correct answer: B

Rationale: When a policy violation occurs, the necessary steps for the nurse manager include: describing the staff nurse's behavior that violated the policy, confrontation as a communication technique to address specific issues, and determining the employee's awareness of the policy. Terminating the employee immediately is not always the appropriate response to a policy violation, as there may be other corrective actions or interventions that can be taken to address the issue without resorting to termination. It is crucial to follow due process, provide guidance, and support to help employees understand and rectify their behavior.

3. The time period to give as notice for an appraisal is:

• A. One day.
• B. None.
• C. One week.
• D. Two days.

Correct answer: D

Rationale: The correct answer is D: 'Two days.' It is preferable to give two days' notice for a performance appraisal. Giving only one day's notice (Choice A) might not provide sufficient time for the employee to prepare adequately for the appraisal. Choice B, 'None,' is incorrect because it is essential to give advance notice for an appraisal to allow the employee time to get ready. Choice C, 'One week,' is too long of a notice period for a standard performance appraisal and could lead to unnecessary delays.

4. A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses?

• A. Moral suffering
• B. Moral distress
• C. Ethical dilemma
• D. Veracity

Correct answer: B

Rationale: The correct answer is B, moral distress. Moral distress occurs when one knows the ethically correct action to take but feels constrained in their ability to take that action due to institutional, hierarchical, or other constraints. In this scenario, the nurses are experiencing uneasiness and discomfort due to an ethical issue, which aligns with the definition of moral distress. Choice A, moral suffering, is not the most appropriate term in this context as moral distress better describes the situation. Choice C, ethical dilemma, refers to a situation where a person is faced with two equally undesirable alternatives, which does not fully capture the nurses' current experience. Choice D, veracity, is unrelated to the nurses' situation and does not fit the context of the scenario.

5. Which of the following factors contributes to conflicts in professional nursing today?

• A. Some nurses who had planned to retire but find themselves forced to continue working because of the current economic situation
• B. Balancing state practice acts, codes of ethics, and standards of practice
• C. Advances in technology
• D. Multiple generations in the workforce

Correct answer: D

Rationale: The presence of multiple generations in the nursing workforce today with diverse viewpoints and work styles can lead to conflicts. This diversity in perspectives and approaches may result in disagreements on how tasks should be done or how patient care should be managed. Option A refers to economic factors impacting individual nurses rather than conflicts within the profession. Option B is related to compliance and ethical considerations, not conflicts. Option C, advances in technology, may influence nursing practices but is not directly linked to conflicts among professionals.

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