Nursing Elites

1. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?

• A. Ask the client to consider a direct donation
• B. Withhold the blood transfusion
• C. Ask the client to consider a direct donation
• D. Request a consultation with the ethics committee

Correct answer: A

Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.

2. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation that should be included in the reminders for ensuring legally credible nursing documentation is to 'Only use approved abbreviations.' Using shortcuts in documentation (Choice A) may lead to incomplete or vague information, compromising the credibility of documentation. Documentation should not be subjective (Choice C) but rather objective and based on factual information. While it is important to document after care is provided (Choice D), the immediate documentation following care provision is critical for accuracy and legal credibility.

3. Which of the following is a common characteristic of a high-performing healthcare team?

• A. Effective communication
• B. Shared leadership
• C. Collaborative decision making
• D. Hierarchical structure

Correct answer: C

Rationale: Collaborative decision making is a key characteristic of a high-performing healthcare team because it involves team members working together to make decisions that lead to the best outcomes for patients. Effective communication is important in any team, but collaborative decision making goes beyond communication by involving team members in the decision-making process. Shared leadership is also crucial for a high-performing team, as it promotes equality and empowerment among team members. On the other hand, a hierarchical structure can hinder effective communication and teamwork by creating barriers between team members and limiting input from all team members, which is counterproductive to achieving optimal healthcare outcomes.

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. What is the primary goal of a root cause analysis (RCA) in healthcare?

• A. To assign blame for errors
• B. To prevent future errors by identifying underlying causes
• C. To improve patient satisfaction
• D. To analyze the financial impact of errors

Correct answer: B

Rationale: The correct answer is B: 'To prevent future errors by identifying underlying causes.' Root cause analysis (RCA) in healthcare aims to delve deep into the factors contributing to an error to prevent its recurrence. Choice A is incorrect as RCA focuses on identifying system issues, not blaming individuals. Choice C is incorrect as while improving patient satisfaction may result from the process, it is not the primary goal. Choice D is incorrect as the main focus of RCA is not financial analysis but rather improving patient safety.

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