Nursing Elites

1. Which of the following conditions would be well suited to the use of a nursing critical pathway?

• A. Foreign object in the ear
• B. Fever of unknown origin
• C. Hip replacement surgery
• D. Bacterial infection acquired in a foreign country

Correct answer: C

Rationale: A critical pathway is designed to track a patient's progress through a specific timeline, including assessments, interventions, treatments, and outcomes. Hip replacement surgery is well suited for a nursing critical pathway because it has a defined timeline with specific interventions and treatments aimed at achieving optimal functioning. Choices A, B, and D do not typically follow a structured timeline with predetermined interventions and outcomes, making them less suitable for a critical pathway.

2. What is the primary role of a nurse in palliative care?

• A. To provide emotional support to patients and families
• B. To coordinate patient care and provide pain management
• C. To administer medications and treatments
• D. To conduct research on end-of-life care

Correct answer: B

Rationale: The correct answer is B. In palliative care, a nurse's primary role is to coordinate patient care and provide pain management. While emotional support (Choice A) is a crucial aspect of palliative care, it is not the primary role of a nurse in this setting. Administering medications and treatments (Choice C) is part of the nurse's responsibilities but not the primary role. Conducting research (Choice D) is important for advancing palliative care but is not the primary role of a nurse providing direct patient care in this context.

3. Which of the following are essential components of strategic planning? (Select all that apply.)

• A. Values
• B. Vision & Mission statements
• C. Reengineering
• D. A & B

Correct answer: D

Rationale: Values and vision and mission statements are indeed essential components of strategic planning. Values help define the organization's core beliefs and principles, guiding its decisions and actions. Vision and mission statements articulate the organization's goals, purpose, and direction, serving as a roadmap for strategic planning and decision-making. Reengineering is not a core component of strategic planning; it involves the redesign of processes to improve performance, efficiency, and quality. Therefore, option C is incorrect. The correct answer is D because both values and vision and mission statements play crucial roles in shaping an organization's strategic planning process.

4. After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?

• A. Recency error
• B. Leniency error
• C. Halo error
• D. Absolute judgment

Correct answer: A

Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.

5. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

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