Nursing Elites

1. 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.

2. A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?

• A. Increase in hematocrit
• B. Increase in respiratory rate
• C. Decrease in heart rate
• D. Decrease in capillary refill time

Correct answer: D

Rationale: The correct answer is D: Decrease in capillary refill time. In a client with fluid volume deficit, improving capillary refill time indicates that the perfusion status is improving due to the increase in fluid volume. Choices A, B, and C are incorrect. An increase in hematocrit may indicate hemoconcentration due to fluid loss, an increase in respiratory rate may suggest respiratory distress, and a decrease in heart rate may not be directly related to fluid volume status.

3. What are the key elements essential to the implementation of case management? (Select all that apply.)

• A. Collaborative practice teams
• B. Established critical pathways
• C. Quality management system
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Established critical pathways, collaborative practice teams, and quality management systems are indeed key elements essential to the implementation of case management. Collaborative practice teams allow for multidisciplinary collaboration, established critical pathways help guide patient care, and a quality management system ensures that care provided meets established standards. Choice A, collaborative practice teams, is correct as they are fundamental for effective case management, involving various professionals working together. Choice B, established critical pathways, is also correct as they provide a structured approach to managing patient care. Choice C, quality management system, is correct as it ensures that care is delivered at high standards and continuously monitored for improvement. Therefore, all these elements are crucial for successful case management implementation.

4. A nurse manager needs to resolve a conflict between the staff nurses and the physical therapy department. What type of power might the manager utilize? (EXCEPT)

• A. Connection and referent power
• B. Reward and punishment power
• C. Legitimate power
• D. Information power

Correct answer: C

Rationale: In this scenario, the nurse manager may utilize various types of power to resolve the conflict between the staff nurses and the physical therapy department. Referent power and connection power are based on respect/admiration and influential links, respectively. Information power is about access to valuable data. Reward power involves offering inducements for cooperation, while punishment power is about imposing penalties for non-compliance. Legitimate power, however, is derived from the manager's authority associated with their job and rank. Since the question asks for the type of power the manager might utilize 'EXCEPT,' legitimate power, being a key type of power often used in managerial roles, is the correct answer. It's important for the nurse manager to understand the dynamics of power and utilize the appropriate types to effectively address interdepartmental conflicts.

5. As a new nurse on a pediatric unit, you must work nights and you have minimal time to spend with your children. Your colleague observes that you speak abruptly with parents and you become easily annoyed when the patients cry or when they are demanding. You realize you are becoming increasingly more distressed and that you have no time with your children and, as a result you: (Select all that apply.)

• A. Express negative comments to colleagues about patients and parents who annoy you.
• B. Ask the nurse manager to have a schedule with an equal number of day and night shifts so that you can be with your children.
• C. Call off sick as frequently as you can without violating policies so that you have more time with your children.
• D. Minimize your communication with patients and parents so you do not offend them.

Correct answer: B

Rationale: The correct answer is B. Asking the nurse manager for a schedule with an equal number of day and night shifts is a proactive and constructive approach to address the issue of having minimal time with your children. This solution aims to balance work and personal life effectively. Choices A, C, and D are incorrect. Expressing negative comments about patients and parents (Choice A) is unprofessional and can create a negative work environment. Calling off sick frequently (Choice C) is irresponsible and violates work policies, leading to potential disciplinary actions. Minimizing communication with patients and parents (Choice D) is not a suitable approach as effective communication is essential in healthcare to provide optimal care and support to patients and their families.

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