Nursing Elites

1. Healthcare systems primarily have functional structures. Which of the following would be an example of this?

• A. Open communication exists between Physical Therapy and Nursing.
• B. Medicine has authority over nursing.
• C. Laboratory services have little authority.
• D. All nursing tasks fall under nursing service.

Correct answer: D

Rationale: The correct answer is D. In functional structures, employees are grouped in departments by specialty, with similar tasks being performed by the same group. This means that in a healthcare system with a functional structure, all nursing tasks would fall under the nursing service. Choices A, B, and C are incorrect because open communication between departments, one department having authority over another, or the level of authority of a particular department do not necessarily represent a functional structure.

2. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

3. As a new nurse on a pediatric unit, you must work nights and you have minimal time to spend with your children. Your colleague observes that you speak abruptly with parents and you become easily annoyed when the patients cry or when they are demanding. You realize you are becoming increasingly more distressed and that you have no time with your children and, as a result you: (Select all that apply.)

• A. Express negative comments to colleagues about patients and parents who annoy you.
• B. Ask the nurse manager to have a schedule with an equal number of day and night shifts so that you can be with your children.
• C. Call off sick as frequently as you can without violating policies so that you have more time with your children.
• D. Minimize your communication with patients and parents so you do not offend them.

Correct answer: B

Rationale: The correct answer is B. Asking the nurse manager for a schedule with an equal number of day and night shifts is a proactive and constructive approach to address the issue of having minimal time with your children. This solution aims to balance work and personal life effectively. Choices A, C, and D are incorrect. Expressing negative comments about patients and parents (Choice A) is unprofessional and can create a negative work environment. Calling off sick frequently (Choice C) is irresponsible and violates work policies, leading to potential disciplinary actions. Minimizing communication with patients and parents (Choice D) is not a suitable approach as effective communication is essential in healthcare to provide optimal care and support to patients and their families.

4. During a discussion about the nursing profession at a middle school, which of the following statements is true?

• A. Nurses need to graduate from nursing school to earn a degree.
• B. Nursing is a profession that values continuous education.
• C. Nurses function autonomously within their scope of practice.
• D. Nurses must adhere to professional behaviors in all aspects of their lives.

Correct answer: C

Rationale: The correct answer is C. Nurses are healthcare professionals who can independently make decisions within their defined scope of practice, providing care to patients. This autonomy allows nurses to assess, diagnose, plan, intervene, and evaluate patient care without direct supervision from physicians. Choice A is incorrect because nurses need to graduate from nursing school to earn a degree, not necessarily to obtain a license. Choice B is incorrect because while continuous education is important in nursing, it is not a defining characteristic of the profession. Choice D is incorrect because while nurses are expected to adhere to professional behaviors, it is not limited to their professional lives but extends to their personal lives as well.

5. As a new nurse at a healthcare organization offering a nurse residency program, what would benefit you the most?

• A. Avoiding challenging patient assignments to minimize the risk of errors.
• B. Relying on your clinical preceptor, similar to your relationship with your nurse faculty.
• C. Establishing professional goals based on your clinical knowledge.
• D. Engaging in evidence-based practice projects immediately.

Correct answer: C

Rationale: As a new nurse joining a nurse residency program, the most beneficial action would be to establish professional goals based on your clinical knowledge. Setting clear goals allows you to focus on your learning needs, competency development, and guidance from your clinical preceptor. This proactive approach helps you maximize your learning opportunities, shape your professional growth, and enhance your skills as a novice nurse. Choice A is incorrect because avoiding challenging patient assignments may hinder your learning and skill development. Choice B is incorrect as while the clinical preceptor is essential, solely relying on them without personal professional goals may limit your growth. Choice D is incorrect because engaging in evidence-based practice projects immediately may be overwhelming for a new nurse without first establishing foundational goals.

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