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. Strategies to advance your career and opportunities available in your first job can coexist. Identify factors that will help you prioritize these opportunities to fulfill your goals. (Select all that apply.)

• A. Self-actualization and assessing your values and your lifestyle.
• B. Determine where you can grow and develop professionally.
• C. Your ability to work as a team member.
• D. Reflect on your long-term career aspirations.

Correct answer: A

Rationale: The correct answer is A. Self-actualization involves assessing your values and lifestyle, which is crucial for prioritizing opportunities that align with your goals. This process helps you understand yourself better and make informed decisions to advance your career. Choice B is incorrect because focusing solely on salary may not necessarily lead to career growth and fulfillment. Choice C is about teamwork skills, which are important but not directly related to prioritizing career opportunities. Choice D is about seeking opinions from others, which may not always align with your personal goals and aspirations.

4. Which of the following best describes the purpose of a root cause analysis (RCA)?

• A. Identify the person responsible for an error
• B. Determine who should be disciplined
• C. Discover the underlying causes of an error
• D. Evaluate the effectiveness of a new policy

Correct answer: C

Rationale: The correct answer is C: 'Discover the underlying causes of an error.' Root cause analysis (RCA) focuses on identifying the fundamental reason(s) that led to an error or problem rather than placing blame on individuals. Choice A and B are incorrect as RCA is not about pinpointing a specific person to blame or determining disciplinary actions. Choice D is also incorrect as the primary goal of RCA is not to evaluate policy effectiveness but to uncover the root causes of issues for effective problem-solving.

5. When facing problems that require immediate action, what organized method involving seven specific steps can nurses use for effective problem-solving?

• A. Nominal group technique
• B. Delphi method
• C. Problem-solving process
• D. Brainstorming

Correct answer: C

Rationale: The correct answer is C: Problem-solving process. The problem-solving process involving seven specific steps is a structured approach that nurses can utilize when immediate action is required. This method allows for a systematic and organized way of addressing urgent issues, ensuring a thorough and effective problem-solving approach. Choices A, B, and D are incorrect because they do not specifically refer to the structured method involving seven specific steps that nurses can follow for effective problem-solving.

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