Nursing Elites

1. Many patient classification systems have some type of shortcoming. Among these are:

• A. The client's condition changes before the next shift.
• B. The staffing needs are predicted on a short-term basis.
• C. The potential admissions cannot be accounted for.
• D. The staffing mix changes because of illness.

Correct answer: C

Rationale: Patient classification systems have limitations in accounting for changes in a client's condition, unexpected influx of new admissions, and changes in staffing due to illness. These systems often focus on short-term staffing needs rather than utilizing demand management, which considers client outcomes to predict staffing needs over a longer period. Not being able to account for potential admissions can lead to challenges in effectively managing staff allocation and resources. Choices A, B, and D are incorrect because they do not address the specific limitation of patient classification systems related to accounting for potential admissions.

2. Organizations are made up of intertwined links and diversified choices that generate unanticipated consequences. This defines which of the following theories?

• A. Contingency theory
• B. Closed system theory
• C. Open system theory
• D. Chaos theory

Correct answer: D

Rationale: The correct answer is D, Chaos theory. Chaos theory is characterized by organizations that are made up of intertwined links and diversified choices that generate unanticipated consequences. Contingency theory (choice A) is based on the idea that there is no one best way to organize and manage a corporation. Closed system theory (choice B) refers to systems that are closed off from the outside environment and do not interact with it. Open system theory (choice C) views organizations as open systems that interact with their external environment.

3. 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 that should be included in the reminders for ensuring legally credible nursing documentation is to 'Only use approved abbreviations.' Using shortcuts in documentation (Choice A) may lead to incomplete or vague information, compromising the credibility of documentation. Documentation should not be subjective (Choice C) but rather objective and based on factual information. While it is important to document after care is provided (Choice D), the immediate documentation following care provision is critical for accuracy and legal credibility.

4. Why is increasing the use of advanced practice nurses encouraged?

• A. A 2010 Institute of Medicine report recommended nurses practice to the full extent of their education.
• B. Advanced practice nurses act as an extension of physicians.
• C. The National League for Nursing advocates for the master of science in nursing (MSN) as the terminal degree for nurse practitioners.
• D. Advanced practice nurses lack the skills to diagnose.

Correct answer: A

Rationale: The correct answer is A because the 2010 Institute of Medicine report recommended that nurses practice to the full extent of their education, which includes utilizing advanced practice nurses. This supports the efficient delivery of healthcare services by leveraging the expertise and skills of advanced practice nurses. Choice B is incorrect as it describes the role of advanced practice nurses rather than providing a reason for increasing their use. Choice C is unrelated to the encouragement of increasing the use of advanced practice nurses as it focuses on the terminal degree for nurse practitioners. Choice D is incorrect as advanced practice nurses do possess the skills necessary to diagnose and provide advanced care, so the statement that they lack diagnostic skills is inaccurate.

5. Which of the following are effective strategies to become more resilient? (EXCEPT)

• A. Exercising and avoiding high-fat foods.
• B. Managing time effectively.
• C. Becoming more self-aware.
• D. Deciding that your career is not your highest priority.

Correct answer: D

Rationale: Resilience can be enhanced through various strategies such as exercising, managing time effectively, and becoming more self-aware. Deciding that your career is not your highest priority may not necessarily contribute to building resilience as it does not directly address the personal traits and coping mechanisms associated with resilience. This choice focuses more on prioritization rather than the specific skills and mindset needed to bounce back from challenges. Sherman's study (2004) highlighted the importance of self-awareness in preventing burnout among nurses, emphasizing the value of self-care and personal well-being in maintaining resilience.

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