Nursing Elites

1. Which of the following best describes the purpose of a root cause analysis (RCA)?

• A. Identify the person responsible for an error
• B. Determine who should be disciplined
• C. Discover the underlying causes of an error
• D. Evaluate the effectiveness of a new policy

Correct answer: C

Rationale: The correct answer is C: 'Discover the underlying causes of an error.' Root cause analysis (RCA) focuses on identifying the fundamental reason(s) that led to an error or problem rather than placing blame on individuals. Choice A and B are incorrect as RCA is not about pinpointing a specific person to blame or determining disciplinary actions. Choice D is also incorrect as the primary goal of RCA is not to evaluate policy effectiveness but to uncover the root causes of issues for effective problem-solving.

2. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: Incompetence jeopardizes patient safety. Therefore, the formal process for handling these practices should be followed.

3. Which regulatory body mandates the provision of immunizations, especially for hepatitis B?

• A. American Nurses Association (ANA)
• B. Occupational Safety and Health Administration (OSHA)
• C. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
• D. State board of nursing

Correct answer: B

Rationale: The correct answer is B - Occupational Safety and Health Administration (OSHA). OSHA mandates that the hepatitis B vaccine series must be offered to healthcare workers who are not immune to hepatitis. This requirement aims to protect healthcare workers from occupational exposure to bloodborne pathogens, including the hepatitis B virus. The American Nurses Association (ANA) (Choice A) is a professional organization for nurses, not a regulatory body. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (Choice C) focuses on accrediting healthcare organizations for quality and safety, not mandating immunizations. The State board of nursing (Choice D) is responsible for regulating nursing practice within a specific state, not mandating immunizations.

4. A technique used to eliminate negative behavior by ignoring the behavior is known as __________.

• A. Punishment
• B. Extinction
• C. Shaping
• D. Equity

Correct answer: B

Rationale: The correct answer is B, 'Extinction.' Extinction is a behavioral psychology technique where undesirable behavior is ignored, leading to its eventual decrease or elimination. This process involves withholding reinforcement that was previously maintaining the behavior. Choice A, 'Punishment,' involves applying negative consequences to reduce unwanted behavior, which is different from extinction. Choice C, 'Shaping,' is a method of gradually molding or reinforcing behaviors to reach a desired behavior, not ignoring negative behavior. Choice D, 'Equity,' refers to fairness and equal treatment, which is unrelated to eliminating negative behavior through ignoring it.

5. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

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