Nursing Elites

1. A Nurse Manager completes an interruption log and identifies two staff members who take an inordinate amount of time with drop-in issues that are not urgent. What are some methods to address this behavior in an attempt to better manage time? (Select all that apply.)

• A. Designate specific time slots for drop-in visits.
• B. Position the desk chair so it is not facing the hallway.
• C. Communicate with staff about using e-mail for non-urgent matters to improve time management.
• D. When staff members drop in, the manager should stand and remain standing during the conversation.

Correct answer: A

Rationale: Designating specific time slots for drop-in visits helps in managing interruptions effectively by consolidating them into designated periods. This approach allows the Nurse Manager to allocate focused time for addressing these issues without disrupting workflow. Option B, repositioning the desk chair, is not a standard strategy for managing time or interruptions. Option C, promoting the use of e-mail for non-urgent matters, may help in some cases but may not entirely address the behavior of extended drop-in visits. Option D, standing during conversations, may not be practical for longer discussions and does not provide a structured approach to address time management issues.

2. There are many ways to ensure that your appraisal system is nondiscriminatory. Which of the following is one way to ensure this?

• A. Giving the appraisal once per year
• B. Having no appeal process
• C. Withholding information from the employee
• D. Not allowing any input from the employee

Correct answer: A

Rationale: To ensure that an appraisal system is nondiscriminatory, one important step is to provide the appraisal once per year. This allows for ongoing evaluation and helps prevent bias. Choice B is incorrect because having no appeal process can lead to unfair treatment without a chance for review. Choice C is incorrect as withholding information from the employee can hinder transparency and objectivity. Choice D is incorrect as not allowing any input from the employee can overlook valuable insights and perspectives that could contribute to a fair evaluation process.

3. A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?

• A. Infuse dextrose 50% by slow IV push.
• B. Administer 1 mg glucagon subcutaneously.
• C. Obtain a glucose reading using a finger stick.
• D. Have the patient drink 4 ounces of orange juice.

Correct answer: C

Rationale: The correct action for the nurse to take first when a patient reports feeling lightheaded and sweaty after being weaned off an insulin drip is to obtain a glucose reading using a finger stick. This will provide crucial information on the patient's current blood glucose level, helping the nurse assess if the symptoms are due to hypoglycemia. Based on the glucose reading, appropriate interventions can be initiated, such as administering dextrose, glucagon, or oral sugars like orange juice if hypoglycemia is confirmed. However, verifying the blood glucose level is the initial step to guide subsequent actions and ensure patient safety.

4. How will working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims affect staff?

• A. Feelings of extreme overload.
• B. Fear of failure.
• C. A pessimistic sense about the world.
• D. Inability to separate intense work situations from personal situations.

Correct answer: B

Rationale: Working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims can lead to feelings of extreme overload, a pessimistic sense about the world, and an inability to separate intense work situations from personal situations. Fear of failure is not specifically mentioned in the context of the question, so it is the correct answer. The constant noises and intense emotional situations can create tension, stress, and negative reactions among staff. Managers can help by assessing the environment, labeling situations, and debriefing with staff to make them more aware of how stressors impact their behaviors.

5. Which of the following is a characteristic of a well-written goal?

• A. Goals should be vague
• B. Goals should be unrealistic
• C. Goals need to be measurable, realistic, and achievable
• D. Goals should be easy to achieve

Correct answer: C

Rationale: The correct answer is C: Goals need to be measurable, realistic, and achievable. Well-written goals should be specific and quantifiable to provide clear direction and motivation. Choice A is incorrect as goals should not be vague but rather specific. Choice B is incorrect as goals should be realistic to be attainable. Choice D is incorrect as goals should challenge individuals and not be too easy to achieve to promote growth and development.

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