Nursing Elites

1. A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?

• A. ''I had a bowel movement, but I was able to save the urine.''
• B. ''I have a specimen in the bathroom from about 30 minutes ago.''
• C. ''I drink a lot, so I will fill up the bottle and complete the test quickly.''
• D. ''I flushed what I urinated at 7:00 a.m. and have saved all urine since.''

Correct answer: C

Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.

2. The complexities of the current health care delivery systems require a variety of leadership styles. Which of the following is one that has emerged in response to these changes?

• A. Quantum
• B. Servant
• C. Autocratic
• D. Democratic

Correct answer: A

Rationale: The correct answer is A: Quantum. The quantum theory of leadership addresses complexity in organizations, making it suitable for the challenges posed by the current health care delivery systems. Servant leadership (choice B) focuses on serving others rather than traditional hierarchies, but it is not specifically tailored to address complexities. Autocratic leadership (choice C) and Democratic leadership (choice D) are more traditional styles that may not be as effective in handling the intricacies of modern health care systems.

3. 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 the RN should include in the reminders is to 'Only use approved abbreviations.' Using shortcuts in documentation (choice A) may lead to errors or omissions, affecting the credibility of documentation. Documentation should be objective (choice C) rather than subjective to ensure accuracy and legal credibility. It is essential to document care promptly after providing it (choice D) to maintain the accuracy and completeness of patient records, but using approved abbreviations is a more specific recommendation to enhance legal credibility.

4. The nurse manager is responsible for implementing a new electronic health record (EHR) system. What is the first step in this process?

• A. Train all staff on the new system
• B. Identify the project team
• C. Develop a training program
• D. Conduct a needs assessment

Correct answer: B

Rationale: The correct first step in implementing a new electronic health record (EHR) system is to identify the project team. This team will be crucial in overseeing the entire implementation process, including tasks like developing a training program (Choice C) and conducting a needs assessment (Choice D). Training all staff on the new system (Choice A) is an important step but typically occurs after the project team has been identified to ensure a smooth and efficient implementation.

5. A group of physicians comes into conflict with the nursing staff of a unit over when AM vital signs are recorded. What type of technique might be used that respects the professionalism of both parties?

• A. Accommodating
• B. Collaboration
• C. Avoiding
• D. Competing

Correct answer: B

Rationale: In this scenario, the most appropriate technique to use is collaboration. Collaboration involves working together with mutual attention to the problem, utilizing the talents of all parties involved. This approach respects the professionalism of both physicians and nursing staff by valuing their input and expertise. Choice A, accommodating, involves giving in to the other party's concerns, which may not fully address the conflict. Choice C, avoiding, suggests ignoring or sidestepping the issue, which does not promote a resolution. Choice D, competing, involves pursuing one's own concerns at the expense of the other party's, leading to a win-lose situation, which is not conducive to resolving conflicts in a professional setting.

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