Nursing Elites

1. 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.

2. A nurse recognizes which of the following as a primary goal of nursing?

• A. Assist patients to achieve a peaceful death.
• B. Improve personal knowledge and skills to enhance patient outcomes.
• C. Advocate for quality of life over the quantity of life.
• D. Work to control costs to enhance patients' quality of life.

Correct answer: A

Rationale: The correct answer is A: 'Assist patients to achieve a peaceful death.' One of the primary goals of nursing is to help patients experience a comfortable and peaceful passing when faced with terminal illness or at the end of life. This involves providing holistic care, managing symptoms, and ensuring that patients are as comfortable and pain-free as possible. Choices B, C, and D are incorrect because while improving knowledge and skills, advocating for quality of life, and controlling costs are important aspects of nursing care, they are not the primary goal related to end-of-life care.

3. Which of the following best describes the concept of resilience in healthcare?

• A. Ability to recover quickly from setbacks
• B. Strict adherence to protocols
• C. Adapting to changing environments
• D. Maintaining consistent performance

Correct answer: A

Rationale: The concept of resilience in healthcare refers to the ability to bounce back and recover quickly from setbacks, such as adverse events, stress, or failures. This resilience allows healthcare professionals to navigate challenges effectively and continue providing quality care to patients. Choice B, strict adherence to protocols, though important, does not fully encompass the flexibility and adaptability required for resilience. Choice C, adapting to changing environments, is closely related to resilience but does not solely define it. Choice D, maintaining consistent performance, is valuable but does not capture the aspect of overcoming setbacks and bouncing back resiliently.

4. The staff nurse is caring for the client with total accountability and is in continual communication with the client, the family, the physicians, and other members of the health care team. This type of nursing delivery system is known as:

• A. Total patient care
• B. Qualified nurse case managers
• C. Established critical pathways
• D. Quality management system

Correct answer: A

Rationale: The correct answer is A: Total patient care. Total patient care is the original model of nursing care delivery, in which one RN has complete responsibility for all aspects of care for one or more patients. In this system, the nurse is accountable for the client's care and maintains continuous communication with the client, their family, physicians, and other healthcare team members. Choice B, Qualified nurse case managers, refers to nurses who coordinate care but do not provide direct hands-on patient care. Choice C, Established critical pathways, involves predefined care plans for specific conditions but does not imply direct accountability as in total patient care. Choice D, Quality management system, relates to processes to ensure and enhance the quality of care but is not specifically about the direct provision of patient care.

5. A nurse manager is considering the variances of the budget. Fewer monies were spent than expected. What type of variance is this?

• A. Unfavorable variance
• B. Favorable variance
• C. Dependent variance
• D. Independent variance

Correct answer: B

Rationale: The correct answer is B, favorable variance. When fewer funds are spent than expected, it indicates efficient budget management, making it a favorable outcome. Choice A, unfavorable variance, is incorrect as it would apply if more money than expected was spent. Choices C and D, dependent variance and independent variance, are unrelated terms in the context of budget variances and do not apply to the situation described.

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