Nursing Elites

1. The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select all that apply.)

• A. Expected length of stay
• B. Assigned healthcare team
• C. Patient outcomes
• D. Medical history

Correct answer: C

Rationale: In developing a critical pathway for congestive heart failure (CHF), it is essential to include patient outcomes. Patient outcomes help guide the care plan and ensure that interventions are effective. The expected length of stay is crucial to plan for resources but is not directly related to the critical pathway components. While the assigned healthcare team is important for care delivery, it is not a standard component of a critical pathway. Medical history is valuable for understanding the patient's background but is not a core component of a critical pathway.

2. A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?

• A. Satisficing
• B. Routine
• C. Adaptive
• D. Rationalizing

Correct answer: A

Rationale: The correct answer is A: Satisficing. Satisficing is a decision-making strategy where the person chooses an alternative that is good enough given the circumstances. In this scenario, the nurse manager is making a satisfactory decision by managing the unit with the three remaining nurses to meet minimal staffing standards despite the reduced availability of staff. Choice B, Routine, does not apply as the decision made in the scenario is not part of a regular or standard procedure. Choice C, Adaptive, is not the best fit as the decision is more about making do with the available resources rather than adapting to a new situation. Choice D, Rationalizing, does not align with the scenario as it refers to justifying decisions rather than making a practical choice under constraints.

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

• A. A patient falling in the hospital without injury
• B. A near-miss medication error
• C. An unexpected patient death unrelated to the natural course of illness
• D. A patient developing an infection during a hospital stay

Correct answer: C

Rationale: The correct answer is C. A sentinel event in healthcare is an unexpected patient death unrelated to the natural course of illness. These events are serious occurrences that warrant immediate investigation and response to prevent their recurrence and ensure patient safety. Choices A, B, and D do not fit the definition of a sentinel event. While choices A, B, and D are serious incidents, they do not involve an unexpected patient death unrelated to the natural course of illness, which is the defining characteristic of a sentinel event.

4. While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.

• A. Parallel
• B. Functional
• C. Service-integrated
• D. Matrix

Correct answer: B

Rationale: The correct answer is B: Functional. In functional structures, employees are grouped into departments based on specialty, allowing individuals with similar skills and tasks to work together efficiently. In this scenario, organizing the hospital into departments such as nursing, dietary, and pharmacy based on their specialties exemplifies a functional organizational structure. Choice A, Parallel structure, involves independent units working on similar tasks, which is not the case here. Choice C, Service-integrated structure, emphasizes cross-functional teamwork across various departments, which is not the main focus in the scenario. Choice D, Matrix structure, involves employees reporting to multiple managers for different projects or tasks, which is not described in the scenario.

5. One reason for conducting a comprehensive medical exam on an applicant is:

• A. It is needed to protect the organization from legal actions.
• B. It is required after a strenuous interview.
• C. It is mandated by law.
• D. It is necessary to screen for disabilities that may impact employment.

Correct answer: A

Rationale: Conducting a comprehensive medical exam on an applicant is crucial to protect the organization from legal actions. This examination helps ensure that the applicant meets the health standards required for the job, reducing the risk of potential liabilities for the organization related to health issues that may arise during employment. Choice B is incorrect because the exam is not a follow-up to a strenuous interview. Choice C is incorrect as not all comprehensive medical exams are mandated by law; they are often part of an organization's policy. Choice D is incorrect as the primary goal of the exam is to assess the applicant's health status in relation to the job requirements, not to screen for disabilities.

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