Nursing Elites

1. 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.

2. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

3. Strategies to advance your career and opportunities available in your first job can coexist. Identify factors that will help you prioritize these opportunities to fulfill your goals. (Select all that apply.)

• A. Self-actualization and assessing your values and your lifestyle.
• B. Determine where you can grow and develop professionally.
• C. Your ability to work as a team member.
• D. Reflect on your long-term career aspirations.

Correct answer: A

Rationale: The correct answer is A. Self-actualization involves assessing your values and lifestyle, which is crucial for prioritizing opportunities that align with your goals. This process helps you understand yourself better and make informed decisions to advance your career. Choice B is incorrect because focusing solely on salary may not necessarily lead to career growth and fulfillment. Choice C is about teamwork skills, which are important but not directly related to prioritizing career opportunities. Choice D is about seeking opinions from others, which may not always align with your personal goals and aspirations.

4. What is the primary role of a nurse in palliative care?

• A. To provide emotional support to patients and families
• B. To coordinate patient care and provide pain management
• C. To administer medications and treatments
• D. To conduct research on end-of-life care

Correct answer: B

Rationale: The correct answer is B. In palliative care, a nurse's primary role is to coordinate patient care and provide pain management. While emotional support (Choice A) is a crucial aspect of palliative care, it is not the primary role of a nurse in this setting. Administering medications and treatments (Choice C) is part of the nurse's responsibilities but not the primary role. Conducting research (Choice D) is important for advancing palliative care but is not the primary role of a nurse providing direct patient care in this context.

5. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation the RN should include in the reminders is to 'Only use approved abbreviations.' Using shortcuts in documentation (choice A) may lead to errors or omissions, affecting the credibility of documentation. Documentation should be objective (choice C) rather than subjective to ensure accuracy and legal credibility. It is essential to document care promptly after providing it (choice D) to maintain the accuracy and completeness of patient records, but using approved abbreviations is a more specific recommendation to enhance legal credibility.

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