Nursing Elites

1. The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select ONE that does not apply.)

• A. Expected length of stay
• B. Assigned staff healthcare provider
• C. Patient outcomes
• D. Medical diagnosis

Correct answer: B

Rationale: Critical pathways are designed to outline the expected sequence and timing of interventions to achieve optimal patient outcomes for a specific medical condition. Components such as the expected length of stay, patient outcomes, and medical diagnosis are crucial in developing a critical pathway for congestive heart failure. However, the assigned staff healthcare provider is not typically a fixed component of a critical pathway as it may vary based on staffing schedules and rotations. Therefore, the assigned staff healthcare provider is the component that does not apply.

2. 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.

3. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

4. What is the primary focus of a patient safety program?

• A. To reduce healthcare costs
• B. To improve clinical outcomes
• C. To enhance patient satisfaction
• D. To comply with regulatory standards

Correct answer: C

Rationale: The primary focus of a patient safety program is to enhance patient satisfaction by ensuring safe practices. While reducing healthcare costs and improving clinical outcomes are important aspects influenced by patient safety programs, the main goal is to prioritize patient well-being and satisfaction. Complying with regulatory standards is essential but not the primary focus; it is a means to achieve safe practices for the benefit of patients.

5. A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?

• A. Pad the client's wrists before applying the restraints.
• B. Evaluate the client's circulation every 8 hours after application.
• C. Secure the restraint ties to the bed's side rails.
• D. Remove the restraints every 4 hours to evaluate the client's status.

Correct answer: C

Rationale: When applying wrist restraints, it is crucial to secure the restraint ties to the bed's side rails to ensure the client's safety and prevent injury. Padding the client's wrists (Choice A) is not a standard practice and may compromise the effectiveness of the restraints. Evaluating the client's circulation (Choice B) is important but should be done more frequently than every 8 hours to ensure prompt detection of any circulation issues. Removing the restraints every 4 hours (Choice D) is unnecessary and may increase the risk of injury or agitation in the client.

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