Nursing Elites

1. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

• A. Hypotension
• B. Distended neck veins
• C. Slow capillary refill
• D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

2. While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.

• A. Parallel
• B. Functional
• C. Service-integrated
• D. Matrix

Correct answer: B

Rationale: The correct answer is 'Functional.' In a functional structure, organizations group employees into departments based on specialty, where similar tasks are performed by the same group. In this scenario, the hospital organizing its departments by specialty such as nursing, dietary, and pharmacy aligns with the characteristics of a functional structure. Choice A, 'Parallel,' does not fit the scenario described; parallel structures involve separate, independent units operating in parallel with little interaction. Choice C, 'Service-integrated,' does not align with the scenario either as it involves integrating services across departments. Choice D, 'Matrix,' is not the correct answer as it involves a complex organizational structure where employees report to multiple managers simultaneously, which is not the case in the scenario provided.

3. After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?

• A. Recency error
• B. Leniency error
• C. Halo error
• D. Absolute judgment

Correct answer: A

Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.

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 responsibility of a nurse manager in a healthcare setting?

• A. To provide direct patient care
• B. To manage healthcare facilities
• C. To oversee administrative tasks
• D. To conduct clinical research

Correct answer: C

Rationale: The correct answer is C: 'To oversee administrative tasks.' Nurse managers in healthcare settings are primarily responsible for managing the administrative aspects of a unit, ensuring smooth operations and efficiency. Choice A is incorrect because providing direct patient care is usually the responsibility of staff nurses, not nurse managers. Choice B is incorrect as managing healthcare facilities involves a broader scope of responsibilities beyond the role of a nurse manager. Choice D is also incorrect as conducting clinical research is typically not a primary responsibility of a nurse manager in a healthcare setting.

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