Nursing Elites

1. Most evaluations are based on absolute judgment. This is:

• A. A standard set by an external source.
• B. The manager and staff's perceived notion.
• C. Internal standards.
• D. The manager's personal opinion.

Correct answer: C

Rationale: The internal standard used in evaluations is the criteria set by the manager, reflecting what they perceive as reasonable and acceptable performance for the employee. Choice A is incorrect because the standard is internal, not set by an external source. Choice B is incorrect as it refers to the collective perception of the manager and staff, rather than the internal standard. Choice D is incorrect as it refers to the manager's personal opinion, which may not always align with the internal standards set for evaluations.

2. A staff nurse is working with a patient who is on a critical pathway for education in preparation for home care. Which one of the following responsibilities would the nurse address first?

• A. Taking vital signs
• B. Answering the client's questions
• C. Evaluating client teaching
• D. Reviewing the information with the client and family

Correct answer: D

Rationale: The correct answer is D. Reviewing the information with the client and family should be addressed first. This step involves ensuring that the client and family fully understand the information provided, which is crucial before proceeding with any other responsibilities. Taking vital signs (choice A) is important but not the priority in this scenario. Answering the client's questions (choice B) and evaluating client teaching (choice C) can come after reviewing the information to ensure effective communication and understanding.

3. There are many ways to ensure that your appraisal system is nondiscriminatory. Which of the following is one way to ensure this?

• A. Giving the appraisal once per year
• B. Having no appeal process
• C. Withholding information from the employee
• D. Not allowing any input from the employee

Correct answer: A

Rationale: To ensure that an appraisal system is nondiscriminatory, one important step is to provide the appraisal once per year. This allows for ongoing evaluation and helps prevent bias. Choice B is incorrect because having no appeal process can lead to unfair treatment without a chance for review. Choice C is incorrect as withholding information from the employee can hinder transparency and objectivity. Choice D is incorrect as not allowing any input from the employee can overlook valuable insights and perspectives that could contribute to a fair evaluation process.

4. Verbal interventions with an agitated patient may be calming. These interventions include:

• A. Holding and reassuring the patient
• B. Encouraging other staff to distract the patient
• C. Remaining calm and keeping an arm's distance
• D. Standing close to the patient while talking

Correct answer: C

Rationale: The correct answer is C: Remaining calm and keeping an arm's distance. Agitated individuals benefit from minimal verbal and physical stimulation. They respond to their environment based on how nurses interact with them. If an individual feels threatened or cornered, the response will generally be self-protective and reactive. Standing close to the patient (choice D) can be perceived as invasive and may escalate the situation. Holding and reassuring the patient (choice A) may not be effective if the patient perceives it as intrusive. Encouraging other staff to distract the patient (choice B) may introduce unnecessary stimulation. Therefore, the recommended approach is to remain calm and keep a safe distance to provide a non-threatening environment for the agitated patient.

5. Which of the following is an important aspect of note-taking?

• A. Not specific and behavior-oriented
• B. Forces the manager to deal with the problem
• C. Records only undesirable events
• D. Failure to give performance feedback

Correct answer: B

Rationale: The correct answer is B: 'Forces the manager to deal with the problem.' Note-taking is essential as it compels the manager to address issues, regardless of their size or nature. This process helps in identifying, documenting, and resolving problems effectively. Choice A is incorrect because note-taking should be specific and focused on behaviors. Choice C is incorrect as note-taking should record all events, not just undesirable ones. Choice D is incorrect as it does not directly relate to the importance of note-taking in addressing problems.

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