Nursing Elites

1. During a performance appraisal, how should the manager best provide constructive feedback to an employee?

• A. Focus only on the negative aspects of performance
• B. Provide general comments without specifics
• C. Discuss specific examples of strengths and areas for improvement
• D. Delay feedback until the next appraisal period

Correct answer: C

Rationale: During a performance appraisal, the best approach to provide constructive feedback is by discussing specific examples of strengths and areas for improvement. This method allows the employee to understand what they are excelling at and where they need to focus on development. By highlighting both aspects, the employee can work on enhancing their performance effectively. Option A is incorrect because solely focusing on the negative aspects can demotivate the employee and hinder their growth. Option B is incorrect as providing general comments without specifics does not offer clear guidance for improvement. Option D is also incorrect as delaying feedback can prevent timely corrective actions and hinder performance progress.

2. An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN�s friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying?

• A. Fidelity
• B. Confidentiality
• C. Veracity
• D. Accountability

Correct answer: B

Rationale: The principle of confidentiality requires nurses to hold healthcare information and anything patients tell them in the strictest confidence.

3. Which of the following laws govern nursing practice?

• A. Statutory laws
• B. Common law
• C. Administrative laws
• D. Constitutional laws

Correct answer: A

Rationale: Statutory laws are laws created by legislative bodies, such as state legislatures. In the context of nursing practice, statutory laws govern areas like licensure requirements, scope of practice, and professional standards. Common law, choice B, is based on court decisions and precedents, not specifically related to nursing practice. Administrative laws, choice C, deal with regulations set by administrative agencies rather than governing nursing practice directly. Constitutional laws, choice D, pertain to the fundamental principles outlined in a country's constitution and are not specific to regulating nursing practice.

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. The ANA recommends that nursing in the health care organization change its focus. This requires a shift from a technical model to which of the following?

• A. Professional
• B. Industrial
• C. Random
• D. Organized

Correct answer: A

Rationale: The correct answer is A: Professional. The American Nurses Association (ANA) recommends shifting the focus in healthcare organizations from a technical model to a professional model. This change emphasizes the level of nurse competence required to provide quality care. Choice B, Industrial, is incorrect as it does not align with the focus on professionalism in nursing. Choice C, Random, is unrelated to the context of the question. Choice D, Organized, while a positive attribute, is not the specific focus recommended by the ANA for nursing in healthcare organizations.

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