Nursing Elites

1. What is the primary focus of a performance appraisal for nursing staff?

• A. To identify areas for salary increases
• B. To evaluate overall job performance
• C. To provide feedback on clinical skills
• D. To determine eligibility for promotions

Correct answer: C

Rationale: The primary focus of a performance appraisal for nursing staff is to provide feedback on clinical skills, identify areas for improvement, and support professional development. While salary increases, overall job performance evaluation, and promotions may be factors considered during a performance appraisal, the primary goal is to assess and enhance clinical skills to ensure high-quality patient care.

2. A nurse is caring for a client who has a nasogastric (NG) tube and is receiving intermittent feedings through an open system. Which of the following actions should the nurse take first?

• A. Make sure the enteral formula is at room temperature.
• B. Wipe the top of the formula can with alcohol.
• C. Rinse the feeding bag with water between feedings.
• D. Tell the client to keep the head of the bed elevated at least 30�

Correct answer: B

Rationale:

3. The manager of a medical-surgical unit is very task-motivated. Using Fiedler's Contingency Theory, under what circumstances would the manager be most effective?

• A. Only during highly stressful situations.
• B. When there is little to no stress.
• C. Under highly structured situations.
• D. When the situation is loosely structured.

Correct answer: C

Rationale: According to Fiedler's Contingency Theory, task-motivated managers are most effective under highly structured situations. This is because in such environments, where priorities are clear and tasks are well-defined, task-oriented managers can excel in organizing and accomplishing objectives efficiently. Choices A and B are incorrect because the effectiveness of a task-motivated manager is not solely linked to stress levels but rather to the structure of the situation. Choice D is also incorrect as a loosely structured situation would not provide the clarity and direction that a task-motivated manager thrives in.

4. Politics is defined as the art of influencing the allocation of scarce resources. An example of a scarce resource allocated by the manager of a patient care unit is:

• A. Raises for the staff.
• B. Patient supplies in the utility room.
• C. Staffing that minimizes overtime.
• D. Paper for the printer.

Correct answer: C

Rationale: In a healthcare setting, scarce resources can include money, time, personnel, and materials. Staffing decisions directly impact the allocation of personnel resources and can affect overtime costs, making it a critical resource managed by the unit manager. Patient supplies in the utility room and paper for the printer are important, but staffing decisions have a more direct impact on resource allocation within the unit. Raises for staff are typically granted by the institution and are not directly controlled by the unit manager.

5. Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)?

• A. The patient�s blood glucose level is 174 mg/dL.
• B. The patient has gained 2 lb (0.9 kg) since yesterday.
• C. The patient is scheduled for a chest x-ray in an hour
• D. The patient�s blood urea nitrogen (BUN) level is 52 mg/dL.

Correct answer: D

Rationale:

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