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. Monitoring the number of times a medication is given utilizing the 'five rights' is an example of which phase of the Six Sigma program?

• A. Measure
• B. Management
• C. Quantitative
• D. Goal

Correct answer: A

Rationale: In the Six Sigma program, the 'Measure' phase focuses on monitoring and measuring processes to ensure they meet the desired standards. This includes tracking the number of times a medication is given correctly using the 'five rights' principle. Therefore, the correct answer is A. Choice B, 'Management,' does not specifically relate to monitoring processes or data collection, so it is not the correct answer. Choice C, 'Quantitative,' refers to the use of numerical data in decision-making, which is a broader concept and not specific to monitoring processes within the Six Sigma framework. Choice D, 'Goal,' is too general and does not capture the specific phase of Six Sigma that involves monitoring and measuring processes.

3. Which of the following best describes the role of a nurse leader?

• A. Managing patient care directly
• B. Enforcing healthcare policies
• C. Inspiring and motivating the healthcare team
• D. Ensuring regulatory compliance

Correct answer: C

Rationale: The correct answer is C: 'Inspiring and motivating the healthcare team.' Nurse leaders play a crucial role in fostering a positive and collaborative work environment by motivating and inspiring their team members. Choice A is incorrect because managing patient care directly is typically the responsibility of staff nurses, while nurse leaders focus on leadership and coordination. Choice B is incorrect as enforcing healthcare policies is usually a function of compliance officers or administrators. Choice D is also incorrect as ensuring regulatory compliance is important but is usually overseen by compliance officers or regulatory affairs specialists, not specifically the role of a nurse leader.

4. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the planning phase of addressing an ethical dilemma, the goals of treatment are established, decision makers are identified, and all available options are reviewed. The assessment phase involves collecting data and information, the diagnosis phase involves analyzing the information to identify the problem, and the implementation phase involves carrying out the chosen plan of action. Therefore, in this scenario, where decision makers are being identified, the RN is in the planning stage.

5. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?

• A. Urine is positive for ketones
• B. Urine has an unusual odor
• C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
• D. Bladder scan shows 525 mL of urine

Correct answer: A

Rationale: The correct answer is A. Ketones in the urine may indicate infection or blockage in the urinary catheter, necessitating irrigation to ensure proper drainage. Choice B, an unusual odor in the urine, may suggest infection but does not directly indicate the need for catheter irrigation. Choice C, a high urine specific gravity, is indicative of concentrated urine but does not specifically point to the need for catheter irrigation. Choice D, a bladder scan showing 525 mL of urine, indicates urine retention, which may require catheterization or further assessment but not necessarily irrigation.

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