Nursing Elites

1. When using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?

• A. Position the client in a side-lying position.
• B. Perform the irrigation using a 20-mL syringe.
• C. Instill 15 mL of irrigation fluid into the catheter with each flush.
• D. Measure and record the amount of irrigant used.

Correct answer: B

Rationale: When irrigating an indwelling urinary catheter, the nurse should use a 20-mL syringe for the procedure. This syringe size helps to provide adequate pressure for effective irrigation. Placing the client in a side-lying position is not necessary for this procedure. Instilling a specific amount of irrigation fluid into the catheter is not mentioned in the scenario. Subtracting the amount of irrigant used from the client's urine output is not a standard practice in catheter irrigation.

2. After discussing alternatives to dressing change procedures to minimize discomfort, the nursing staff accepted a new procedure. This is an example of which stage of Havelock's model of change?

• A. Moving
• B. Self-renewal
• C. Refreezing
• D. Unfreezing

Correct answer: A

Rationale: The correct answer is A: Moving. In the moving stage of Havelock's model of change, the focus is on selecting a solution or alternative. In this scenario, the nursing staff accepting a new procedure after discussing alternatives aligns with the moving stage, where the decision to adopt a change is made. Choices B, C, and D are incorrect. Self-renewal refers to personal growth, refreezing involves stabilizing the change, and unfreezing is related to preparing for change, none of which directly correspond to the situation described in the question.

3. Many patient classification systems have some type of shortcoming. Among these are:

• A. The client's condition changes before the next shift.
• B. The staffing needs are predicted on a short-term basis.
• C. The potential admissions cannot be accounted for.
• D. The staffing mix changes because of illness.

Correct answer: C

Rationale: Patient classification systems have limitations in accounting for changes in a client's condition, unexpected influx of new admissions, and changes in staffing due to illness. These systems often focus on short-term staffing needs rather than utilizing demand management, which considers client outcomes to predict staffing needs over a longer period. Not being able to account for potential admissions can lead to challenges in effectively managing staff allocation and resources. Choices A, B, and D are incorrect because they do not address the specific limitation of patient classification systems related to accounting for potential admissions.

4. On a voting ballot, the individuals who are to be elected during a vote are called:

• A. Representatives.
• B. Candidates.
• C. Bargaining agents.
• D. Electorate.

Correct answer: B

Rationale: The correct term for individuals who are to be elected during a vote is 'Candidates.' On a voting ballot, voters choose among the candidates running for a particular position or office. 'Representatives' (Choice A) are individuals who have already been elected to represent a group of people. 'Bargaining agents' (Choice C) typically refer to individuals negotiating on behalf of others, not those being elected. 'Electorate' (Choice D) refers to all the people in a country or area who are entitled to vote in an election, not specifically the candidates themselves.

5. A manager identifies that he is spending more time than desired on completing repetitive paperwork. Which of the following would be appropriate ways to address this issue? (EXCEPT)

• A. Combining data reports to reduce duplication
• B. Delegating staff evaluations to the staff nurse on the unit with the most experience
• C. Assigning the preliminary draft of the schedule to a subcommittee of staff nurses
• D. Saying no to inappropriate paperwork assignments

Correct answer: B

Rationale: Delegating staff evaluations to a staff nurse, even if experienced, is not appropriate as it falls outside their scope and responsibility. Choices A, C, and D are suitable ways to address the issue of spending excessive time on repetitive paperwork. Combining data reports, assigning the preliminary draft of the schedule to a subcommittee of staff nurses, and saying no to inappropriate paperwork assignments are all effective strategies to streamline processes and reduce managerial workload.

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