Nursing Elites

1. If a staff member does not respond to discipline, the manager must ______ employment.

• A. Terminate
• B. Confront
• C. Describe the staff nurse's behavior that violated the policy
• D. Determine the employee's awareness of the policy

Correct answer: A

Rationale: When an employee does not respond to disciplinary measures, termination may be necessary. This is a last resort for managers when other strategies to improve performance have failed. Terminating an employee means ending their employment with the organization. Choices B, C, and D are incorrect as the question specifically asks what action the manager must take when an employee does not respond to discipline. Confronting the employee, describing the behavior, or determining awareness of the policy are steps that may precede termination but are not the final action to be taken.

2. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: Incompetence jeopardizes patient safety. Therefore, the formal process for handling these practices should be followed.

3. What is the primary role of the nurse manager in risk management?

• A. Ensure compliance with regulations
• B. Report incidents to higher authorities
• C. Minimize risks to patients and staff
• D. Educate staff about safe practices

Correct answer: C

Rationale: The correct answer is C: Minimize risks to patients and staff. Nurse managers play a crucial role in risk management by identifying potential risks, implementing strategies to reduce or eliminate these risks, and ensuring a safe environment for patients and staff. Choice A is incorrect because while ensuring compliance with regulations is important, the primary role of the nurse manager in risk management is to minimize risks. Choice B is incorrect as reporting incidents is part of risk management but not the primary role of a nurse manager. Choice D is also a responsibility of nurse managers, but educating staff about safe practices is not the primary focus when it comes to risk management.

4. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

5. Which of the following best describes the concept of resilience in healthcare?

• A. Ability to recover quickly from setbacks
• B. Strict adherence to protocols
• C. Adapting to changing environments
• D. Maintaining consistent performance

Correct answer: A

Rationale: The concept of resilience in healthcare refers to the ability to bounce back and recover quickly from setbacks, such as adverse events, stress, or failures. This resilience allows healthcare professionals to navigate challenges effectively and continue providing quality care to patients. Choice B, strict adherence to protocols, though important, does not fully encompass the flexibility and adaptability required for resilience. Choice C, adapting to changing environments, is closely related to resilience but does not solely define it. Choice D, maintaining consistent performance, is valuable but does not capture the aspect of overcoming setbacks and bouncing back resiliently.

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