Nursing Elites

1. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision-makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the ethical decision-making process, after identifying the decision-makers involved, the next step is typically planning. During the planning stage, the RN will consider the available options, weigh the ethical principles involved, and develop a course of action to address the ethical dilemma. Choice A, Assessment, involves gathering information and data about the situation. Choice B, Diagnosis, involves analyzing the gathered information to identify the ethical issue. Choice D, Implementation, comes after planning and involves putting the chosen course of action into practice.

2. In order to assist an older diabetic patient to engage in moderate daily exercise, which action is most important for the nurse to take?

• A. Determine what type of activities the patient enjoys.
• B. Remind the patient that exercise will improve self-esteem.
• C. Teach the patient about the effects of exercise on glucose levels.
• D. Give the patient a list of activities that are moderate in intensity.

Correct answer: A

Rationale: The correct answer is to determine what type of activities the patient enjoys. This approach is crucial as it helps in personalizing the exercise plan to the patient's preferences, making it more likely for them to adhere to it. Choice B is incorrect because focusing on self-esteem may not directly motivate the patient to engage in exercise. Choice C, although important, may not be the initial step as understanding the patient's preferences comes first. Choice D limits the patient's autonomy by not involving them in the decision-making process.

3. Which of the following is an example of a sentinel event?

• A. A patient fall with no injury
• B. A medication error that results in no harm
• C. A patient suicide while in a healthcare facility
• D. A near miss incident

Correct answer: C

Rationale: The correct answer is C, a patient suicide while in a healthcare facility. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury. Choices A, B, and D do not meet the criteria for sentinel events as described by The Joint Commission, as they do not involve death or serious harm to the patient.

4. Factors that may contribute to workplace violence in a health care setting include:

• A. Lack of armed security
• B. Continuous loud noises and/or poorly monitored entrances
• C. Poor staff interactions
• D. Tense shoulders and clenched fists

Correct answer: B

Rationale: The correct answer is B. Continuous loud noises and poorly monitored entrances can contribute to workplace violence by creating a chaotic environment that can escalate tensions. Factors like lack of armed security (choice A) may not be as significant in triggering violence as environmental factors. Poor staff interactions (choice C) can contribute to a negative work culture but may not directly lead to violence. Tense shoulders and clenched fists (choice D) may indicate stress or anger in an individual but are not factors that contribute to workplace violence in general.

5. The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions would be which of the following strategies?

• A. Verifying through feedback
• B. Follow-up communication
• C. Getting positive attention
• D. Knowing the context of the instruction

Correct answer: A

Rationale: Asking the subordinate to repeat the instructions is a strategy known as verifying through feedback. This approach ensures that the receiver has understood the request correctly. Choice B, 'Follow-up communication,' refers to checking in after the initial communication, not necessarily asking for repetition. Choice C, 'Getting positive attention,' is unrelated to confirming understanding. Choice D, 'Knowing the context of the instruction,' deals with understanding the background or reasons behind the instructions, not confirming comprehension.

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