Nursing Elites

1. When should a critical pathway be revised?

• A. When variances show a new trend.
• B. When the variances show a new trend.
• C. When a member of the team retires.
• D. When the client leaves the hospital.

Correct answer: B

Rationale: A critical pathway should be revised when variances in the patient's progress indicate a new trend or deviation from the expected course of treatment. This allows healthcare providers to adjust the pathway to ensure optimal patient care and outcomes. Changes in the critical pathway are not typically driven by its length or external factors like team member retirements or client discharges. Therefore, the correct answer is B. Choice A is a better phrasing of the correct answer, emphasizing the importance of variances showing a new trend. Choices C and D are irrelevant to the patient's progress and treatment plan, making them incorrect.

2. 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.

3. A nurse enters a client's room and finds them on the floor. The client's roommate reports that the client was trying to get out of bed and fell over the side rail onto the floor. Which of the following statements should the nurse document about this incident?

• A. Incident report completed.
• B. Client climbed over the side rails.
• C. Client was trying to get out of bed.
• D. Client found lying on floor.

Correct answer: C

Rationale: The correct answer is C: "Client was trying to get out of bed." This statement accurately reflects the sequence of events leading to the client's fall and provides crucial information for assessing the situation. Choice A is incorrect because documenting the completion of an incident report is not relevant to describing the incident itself. Choice B incorrectly states that the client climbed over the side rails, which is not supported by the information provided. Choice D is too vague and does not provide details about the client's actions prior to falling.

4. Which of the following are important techniques when giving directions to subordinates? (EXCEPT)

• A. Know the context of the instructions.
• B. Use lateral communication.
• C. Verify feedback.
• D. Get positive attention.

Correct answer: B

Rationale: The correct answer is B: 'Use lateral communication.' When giving directions to subordinates, it is important to know the context of the instructions, get positive attention, verify feedback, and give follow-up communication. Lateral communication refers to communication between individuals or groups on the same organizational level, which is not directly related to giving directions to subordinates. Choices A, C, and D are important techniques that help ensure effective communication with subordinates.

5. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?

• A. Carefully assess and document client status.
• B. Ensure all patient information is logged out and the nurse has signed out of the computer before leaving the computer station.
• C. Keep careful notes while providing care to ensure accurate documentation later in the day.
• D. Discuss safety needs with clients.

Correct answer: A

Rationale: The correct answer is A: Carefully assess and document client status. By carefully assessing and documenting the client's status, healthcare providers can ensure they have a clear understanding of the client's condition, needs, and any potential risks. This helps in providing appropriate care and avoiding situations that may lead to charges of negligence or false imprisonment. Choice B is incorrect because logging out of computer systems is more related to data security and confidentiality rather than preventing negligence or false imprisonment. Choice C is not directly related to avoiding charges of negligence and false imprisonment but rather ensuring accurate documentation. Choice D, while important for overall client safety, does not specifically address the issue of avoiding charges of negligence and false imprisonment for confused clients.

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