Nursing Elites

1. After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?

• A. Recency error
• B. Leniency error
• C. Halo error
• D. Absolute judgment

Correct answer: A

Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.

2. Which statement by the patient indicates a need for additional instruction in administering insulin?

• A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
• B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
• C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
• D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'

Correct answer: A

Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.

3. Which of the following best describes the role of a nurse preceptor?

• A. Supervisor of all nursing staff
• B. Mentor and educator for new nurses
• C. Director of nursing services
• D. Coordinator of patient care

Correct answer: B

Rationale: The correct answer is B: 'Mentor and educator for new nurses.' A nurse preceptor plays a crucial role in mentoring and educating new nurses. They provide guidance, support, and practical knowledge to help new nurses transition smoothly into their roles. While preceptors may have supervisory responsibilities during the orientation period, their primary focus is on supporting the professional development of new nurses, rather than supervising all nursing staff, directing nursing services, or coordinating patient care. Choice A is incorrect because a nurse preceptor does not supervise all nursing staff but focuses on new nurses. Choice C is incorrect as the role of a director of nursing services involves overall management and leadership of nursing services. Choice D is incorrect as a coordinator of patient care is responsible for organizing patient care activities, not specifically focused on mentoring new nurses.

4. What is the main goal of discharge planning?

• A. To ensure that patients are discharged as quickly as possible
• B. To prevent hospital readmissions
• C. To educate patients about their medications
• D. To transition patients from one level of care to another

Correct answer: B

Rationale: The main goal of discharge planning is to prevent hospital readmissions by ensuring patients have a clear and effective plan for post-discharge care. This includes coordinating follow-up appointments, medication management, and providing necessary support services to promote a successful transition from the hospital to home or another care setting. Choices A, C, and D are incorrect because discharge planning is not primarily about speedy discharge, medication education, or transitioning between care levels; its main focus is on preventing readmissions through comprehensive post-discharge care.

5. 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.

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