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. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

• A. Hypotension
• B. Distended neck veins
• C. Slow capillary refill
• D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

3. The ANA is a registered labor organization, but it does not engage in direct __________.

• A. Empower union affiliation
• B. Reward union affiliation
• C. Encourage union affiliation
• D. Collective bargaining

Correct answer: D

Rationale: The correct answer is D, 'Collective bargaining.' The American Nurses Association is a registered labor organization, but it does not engage in direct collective bargaining. The actual certification of units, negotiation of contracts, and administration of contracts is conducted by the state nurses associations (SNAs). Choices A, B, and C are incorrect as the ANA's role does not involve empowering, rewarding, or encouraging union affiliation directly.

4. Which of the following are important techniques when giving directions to subordinates? (EXCEPT)

• A. Know the context of the instructions.
• B. Use lateral communication.
• C. Verify feedback.
• D. Get positive attention.

Correct answer: B

Rationale: The correct answer is B: 'Use lateral communication.' When giving directions to subordinates, it is important to know the context of the instructions, get positive attention, verify feedback, and give follow-up communication. Lateral communication refers to communication between individuals or groups on the same organizational level, which is not directly related to giving directions to subordinates. Choices A, C, and D are important techniques that help ensure effective communication with subordinates.

5. The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select all that apply.)

• A. Expected length of stay
• B. Assigned healthcare team
• C. Patient outcomes
• D. Medical history

Correct answer: C

Rationale: In developing a critical pathway for congestive heart failure (CHF), it is essential to include patient outcomes. Patient outcomes help guide the care plan and ensure that interventions are effective. The expected length of stay is crucial to plan for resources but is not directly related to the critical pathway components. While the assigned healthcare team is important for care delivery, it is not a standard component of a critical pathway. Medical history is valuable for understanding the patient's background but is not a core component of a critical pathway.

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