Nursing Elites

1. A Staff Nurse submits a six-week notice of resignation. The Nurse Manager prepares a request to immediately post the position and begin interviews. This action is best described as which of the following?

• A. Delegation
• B. A time-waster
• C. Reactive management
• D. Proactive management

Correct answer: D

Rationale: The correct answer is D, Proactive management. Proactive management involves taking steps to prevent issues from occurring rather than just reacting to them. In this scenario, the Nurse Manager is being proactive by preparing to fill the position before the Staff Nurse leaves, thereby preventing short staffing. Choices A, B, and C are incorrect. Delegation refers to assigning tasks to others, not preparing to fill a vacant position. Calling it a time-waster is subjective and not reflective of the manager's proactive approach. Reactive management would involve waiting until the Nurse leaves and then trying to fill the position, causing short staffing.

2. What are the key elements essential to the implementation of case management? (Select all that apply.)

• A. Collaborative practice teams
• B. Established critical pathways
• C. Quality management system
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Established critical pathways, collaborative practice teams, and quality management systems are indeed key elements essential to the implementation of case management. Collaborative practice teams allow for multidisciplinary collaboration, established critical pathways help guide patient care, and a quality management system ensures that care provided meets established standards. Choice A, collaborative practice teams, is correct as they are fundamental for effective case management, involving various professionals working together. Choice B, established critical pathways, is also correct as they provide a structured approach to managing patient care. Choice C, quality management system, is correct as it ensures that care is delivered at high standards and continuously monitored for improvement. Therefore, all these elements are crucial for successful case management implementation.

3. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?

• A. BUN 21 mg/dL (10 to 20 mg/dL)
• B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
• C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
• D. Sodium 132 mEq/L (136 to 145 mEq/L)

Correct answer: B

Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.

4. A nurse is discussing the responsibility of caring for clients with clostridium difficile infection. Which of the following information should the nurse include in the teaching?

• A. Have family members wear a gown and gloves when visiting.
• B. Clean contaminated surfaces in the client's room with a bleach solution.
• C. Use alcohol-based hand sanitizer when leaving the client's room.
• D. Assign the client to a room with a private bathroom.

Correct answer: A

Rationale: When caring for clients with clostridium difficile infection, it is important to prevent the spread of the bacteria. Having family members wear a gown and gloves when visiting helps reduce the risk of transmission. Cleaning contaminated surfaces with a bleach solution, not phenol, is recommended to effectively kill the C. difficile spores. Using alcohol-based hand sanitizer is not sufficient, as it may not be effective against C. difficile spores. Assigning the client to a room with a private bathroom is more beneficial than a negative airflow system, as it helps prevent the spread of bacteria to other clients.

5. A nurse manager is considering the variances of the budget. Fewer monies were spent than expected. What type of variance is this?

• A. Unfavorable variance
• B. Favorable variance
• C. Dependent variance
• D. Independent variance

Correct answer: B

Rationale: The correct answer is B, favorable variance. When fewer funds are spent than expected, it indicates efficient budget management, making it a favorable outcome. Choice A, unfavorable variance, is incorrect as it would apply if more money than expected was spent. Choices C and D, dependent variance and independent variance, are unrelated terms in the context of budget variances and do not apply to the situation described.

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