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. When in opposition to an immediate superior, a nurse manager should use which important strategy in a confrontation?

• A. Using 'I' language
• B. Using absolutes
• C. Using 'why' questions
• D. Using negative assertions

Correct answer: A

Rationale: When in a confrontation, using 'I' language is crucial for a nurse manager. This approach allows the manager to express personal feelings without sounding accusatory, which can help reduce defensiveness and promote open communication. Choices B, C, and D are incorrect. Using absolutes can come off as rigid and may escalate the conflict. 'Why' questions can be perceived as confrontational and may put the other person on the defensive. Negative assertions can lead to a more hostile exchange rather than fostering a constructive dialogue.

3. Two RNs are discussing the benefits of professional liability insurance. Which of the following is a reason for an RN to have a professional liability insurance policy?

• A. No expenses are involved in frivolous lawsuits.
• B. If a nurse is found guilty of malpractice, the institution can sue the nurse.
• C. Liability policies may also cover charges of libel, slander, assault, and HIPAA violations.
• D. Only doctors are sued for malpractice.

Correct answer: C

Rationale: Professional liability insurance is essential for nurses to have as it may cover charges of libel, slander, assault, and HIPAA violations. Option A is incorrect as there are expenses involved in frivolous lawsuits. Option B is incorrect because if a nurse is found guilty of malpractice, the institution can sue the nurse. Option D is incorrect as nurses can also be sued for malpractice, not just doctors.

4. In order to minimize or avoid negative outcomes as a result of the violation and disciplinary action, the employee should offer which of the following?

• A. Excuses
• B. Discipline
• C. Suggestions
• D. Rules

Correct answer: C

Rationale: In order to minimize or avoid negative outcomes resulting from a violation and disciplinary action, the employee should offer suggestions. By providing suggestions, the employee demonstrates a willingness to improve and prevent future occurrences. Offering excuses (choice A) may deflect responsibility and not address the issue at hand. Discipline (choice B) is the action taken by the employer, not the employee. Rules (choice D) are guidelines to follow, but in this context, offering suggestions for improvement is more relevant.

5. After correcting the IVF infusion 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 correcting the IVF infusion rate is to complete an incident report. This report is crucial for documenting the event, identifying the root cause of the error, and implementing measures to prevent 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 be necessary later but ensuring patient safety and proper documentation come first. Disciplining the previous nurse should be handled through the appropriate professional channels, not as an immediate response to the incident. Legal consultation may be needed in some cases but is not the initial step required after correcting the error and ensuring the client's safety.

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