Nursing Elites

1. Which of the following is a common characteristic of a high reliability organization (HRO)?

• A. Flexibility
• B. Reluctance to simplify
• C. Preoccupation with failure
• D. Deference to expertise

Correct answer: C

Rationale: A common characteristic of a high reliability organization (HRO) is a preoccupation with failure. HROs focus on identifying and addressing potential failure points to prevent errors and maintain high levels of safety and reliability. This mindset helps them anticipate and mitigate risks proactively, leading to better outcomes and performance. Choices A, B, and D are incorrect. While flexibility, reluctance to simplify, and deference to expertise may be important in various contexts, they are not the primary defining characteristics of a high reliability organization. The core focus of HROs is on continuously monitoring for potential failures and working to prevent them.

2. 1. Which patient action indicates good understanding of the nurse�s teaching about administration of aspart (NovoLog) insulin?

• A. The patient avoids injecting the insulin into the upper abdominal area
• B. The patient cleans the skin with soap and water before insulin administration.
• C. The patient stores the insulin in the freezer after administering the prescribed dose.
• D. The patient pushes the plunger down while removing the syringe from the injection site

Correct answer: B

Rationale:

3. A client experiences difficulty breathing after the change of shift. The nurse on duty discovers that the IVFs were infusing at a rate 10 times the calculated normal. After notifying the physician and correcting the rate, what should be the next step in the client's care?

• A. Notify family
• B. Discipline the previous nurse
• C. Complete an incident report
• D. Obtain legal consultation

Correct answer: C

Rationale: The correct next step in the client's care after notifying the physician and correcting the rate of IVFs is to complete an incident report. This report is essential for documenting the adverse event, analyzing the cause, and implementing preventive measures to avoid similar incidents in the future. Notifying the family, disciplining the previous nurse, and obtaining legal consultation are not immediate priorities in this situation. Family notification may follow the incident report, disciplining the previous nurse is a separate administrative process, and legal consultation is usually not required for a medical error corrected promptly.

4. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: A DNR order can be written after the health-care provider has discussed it with the client and family.

5. Which of the following best describes the role of a nurse navigator?

• A. Provide direct patient care
• B. Coordinate complex care
• C. Assist with administrative tasks
• D. Manage clinical trials

Correct answer: B

Rationale: A nurse navigator's primary role is to coordinate complex care for patients, guiding them through the healthcare system. Choice A is incorrect because nurse navigators do not provide direct patient care like nurses in clinical settings. Choice C is incorrect as nurse navigators focus on patient care coordination rather than administrative tasks. Choice D is incorrect as managing clinical trials is typically not within the scope of a nurse navigator's responsibilities.

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