Nursing Elites

1. Which of the following is an essential element of a quality improvement (QI) program?

• A. Blame and punishment
• B. Employee satisfaction
• C. Continual monitoring
• D. Strict adherence to policies

Correct answer: C

Rationale: The essential element of a quality improvement (QI) program is continual monitoring. Continual monitoring allows for the ongoing assessment of processes, identification of areas for improvement, and tracking of progress. Option A, 'Blame and punishment,' is incorrect as QI programs focus on systemic issues rather than individual blame. Option B, 'Employee satisfaction,' while important for organizational culture, is not an essential element of QI programs. Option D, 'Strict adherence to policies,' is valuable but not the core essential element, which is continual monitoring to drive improvement.

2. Which of the following is a primary responsibility of a nurse case manager?

• A. Direct patient care
• B. Financial planning
• C. Conduct health education
• D. Coordinate patient transitions

Correct answer: D

Rationale: A primary responsibility of a nurse case manager is to coordinate patient transitions. This involves ensuring smooth transitions between healthcare settings, coordinating care plans, and ensuring continuity of care for patients. While direct patient care, financial planning, and health education are important aspects of healthcare, they are not primary responsibilities of a nurse case manager. Nurse case managers focus on managing and coordinating the overall care and services for patients.

3. When a client experiences a major incident, what is the time frame for reporting the incident?

• A. 24 hours.
• B. 36 hours.
• C. 48 hours.
• D. 72 hours.

Correct answer: A

Rationale: The correct answer is A: '24 hours.' It is crucial to report a major incident within 24 hours of its occurrence to ensure timely and accurate documentation. Reporting incidents promptly allows for a swift response and investigation to prevent future occurrences. Choices B, C, and D are incorrect as they exceed the recommended time frame for reporting a major incident, which is 24 hours.

4. A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?

• A. Amitriptyline decreases the depression caused by your foot pain.
• B. Amitriptyline helps prevent transmission of pain impulses to the brain.
• C. Amitriptyline corrects some of the blood vessel changes that cause pain.
• D. Amitriptyline improves sleep and reduces awareness of nighttime pain.

Correct answer: B

Rationale: The correct answer is B. Amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, which helps in reducing the transmission of pain impulses to the brain. Choice A is incorrect because amitriptyline primarily works on pain transmission rather than directly on depression. Choice C is inaccurate as amitriptyline's mechanism of action is not related to correcting blood vessel changes. Choice D is partially true as amitriptyline can improve sleep, but the primary mechanism related to pain relief is by preventing pain impulses from reaching the brain.

5. How can a staff nurse recognize they are experiencing burnout? (EXCEPT)

• A. They are spending more time talking to staff on other units.
• B. Staff is questioning their clinical judgment.
• C. They sleep longer hours, sometimes coming in late to work.
• D. They are drinking alcohol more frequently to relax.

Correct answer: A

Rationale: Recognizing burnout is essential to maintaining quality patient care. Spending more time talking to staff on other units is a common practice and does not necessarily indicate burnout. On the other hand, staff questioning their clinical judgment, sleeping longer hours or coming in late to work, and resorting to alcohol to relax are signs of burnout. These behaviors can impact patient care and indicate the professional is struggling to cope with stressors.

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