Nursing Elites

1. A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?

• A. Pad the client's wrists before applying the restraints.
• B. Evaluate the client's circulation every 8 hours after application.
• C. Secure the restraint ties to the bed's side rails.
• D. Remove the restraints every 4 hours to evaluate the client's status.

Correct answer: C

Rationale: When applying wrist restraints, it is crucial to secure the restraint ties to the bed's side rails to ensure the client's safety and prevent injury. Padding the client's wrists (Choice A) is not a standard practice and may compromise the effectiveness of the restraints. Evaluating the client's circulation (Choice B) is important but should be done more frequently than every 8 hours to ensure prompt detection of any circulation issues. Removing the restraints every 4 hours (Choice D) is unnecessary and may increase the risk of injury or agitation in the client.

2. 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.

3. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?

• A. Carefully assess and document client status.
• B. Ensure all patient information is logged out and the nurse has signed out of the computer before leaving the computer station.
• C. Keep careful notes while providing care to ensure accurate documentation later in the day.
• D. Discuss safety needs with clients.

Correct answer: A

Rationale: The correct answer is A: Carefully assess and document client status. By carefully assessing and documenting the client's status, healthcare providers can ensure they have a clear understanding of the client's condition, needs, and any potential risks. This helps in providing appropriate care and avoiding situations that may lead to charges of negligence or false imprisonment. Choice B is incorrect because logging out of computer systems is more related to data security and confidentiality rather than preventing negligence or false imprisonment. Choice C is not directly related to avoiding charges of negligence and false imprisonment but rather ensuring accurate documentation. Choice D, while important for overall client safety, does not specifically address the issue of avoiding charges of negligence and false imprisonment for confused clients.

4. Achieving Magnet Hospital designation offers hospitals the following advantages: (Select one that does not apply.)

• A. Greater client satisfaction.
• B. Improved nursing recruitment.
• C. Greater client workload.
• D. Nurses who are independent decision makers.

Correct answer: C

Rationale: The correct answer is C. Achieving Magnet Hospital designation provides advantages such as greater client satisfaction, improved nursing recruitment, and nurses who are independent decision makers. However, the statement about 'Greater client workload' is not a typical advantage associated with Magnet recognition. Organizations that achieve Magnet recognition focus on improving nursing work environments, empowering nurses, and enhancing patient care quality, rather than increasing client workload. Therefore, C is the correct choice. Choices A, B, and D are incorrect because they align with the benefits of achieving Magnet Hospital designation as they lead to increased satisfaction, better recruitment, and more empowered nurses.

5. When a client experiences a major incident, what is the time frame for reporting the incident?

• A. 24 hours.
• B. 36 hours.
• C. 48 hours.
• D. 72 hours.

Correct answer: A

Rationale: The correct answer is A: '24 hours.' It is crucial to report a major incident within 24 hours of its occurrence to ensure timely and accurate documentation. Reporting incidents promptly allows for a swift response and investigation to prevent future occurrences. Choices B, C, and D are incorrect as they exceed the recommended time frame for reporting a major incident, which is 24 hours.

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