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. If the nurse and nurse manager did not resolve the situation related to the physician's report about the nurse's performance, what is the length of time allowed for the nurse to submit an appeal?

• A. 10 days
• B. 15 days
• C. 20 days
• D. 30 days

Correct answer: A

Rationale: If the informal discussion between the nurse and nurse manager does not resolve the issue regarding the physician's report on the nurse's performance, the nurse can submit a written appeal within 10 days, according to the healthcare facility policy. This 10-day timeframe ensures a prompt resolution of disputes and maintains clear communication channels within the healthcare setting. Choices B, C, and D are incorrect as they exceed the time limit allowed for the nurse to submit an appeal, which is specified to be 10 days.

3. Which of the following are considered part of the operating expenses within health care organizations? (EXCEPT)

• A. Maintenance costs
• B. Rental fees
• C. Renovation costs
• D. Supplies

Correct answer: C

Rationale: Operating expenses in health care organizations typically include costs like maintenance, rental fees, and supplies as they are necessary for the day-to-day operations. Renovation costs, on the other hand, are considered capital expenses as they involve significant improvements to facilities rather than routine operational expenses. Therefore, the correct answer is C. Choices A, B, and D are part of operating expenses in health care organizations because they directly contribute to the ongoing operational needs.

4. The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select ONE that does not apply.)

• A. Expected length of stay
• B. Assigned staff healthcare provider
• C. Patient outcomes
• D. Medical diagnosis

Correct answer: B

Rationale: Critical pathways are designed to outline the expected sequence and timing of interventions to achieve optimal patient outcomes for a specific medical condition. Components such as the expected length of stay, patient outcomes, and medical diagnosis are crucial in developing a critical pathway for congestive heart failure. However, the assigned staff healthcare provider is not typically a fixed component of a critical pathway as it may vary based on staffing schedules and rotations. Therefore, the assigned staff healthcare provider is the component that does not apply.

5. Politics is a means for influencing events and the decisions of others. The nurse manager who consistently reminds the staff that 'there is no I in team' and periodically brings treats for the staff is using:

• A. Image enhancement
• B. Political skills
• C. Reward power
• D. Expert power

Correct answer: B

Rationale: The correct answer is B: Political skills. Politics involve interpersonal endeavors, collective activities, analysis, planning, and managing image. In this scenario, the nurse manager is skillfully building team morale and influencing staff dynamics by emphasizing teamwork ('there is no I in team') and boosting morale through occasional treats. This demonstrates the use of political skills to influence and manage relationships within the team. Choices A, C, and D are incorrect because the manager's actions are not solely focused on image enhancement, reward power, or expert power. Instead, they are aimed at fostering teamwork and boosting staff morale.

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