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 describes the ability to enter into a contract with an employer?

• A. Certification to contract
• B. Certification to represent
• C. Bargaining agreement
• D. Contract agreement

Correct answer: A

Rationale: The correct answer is A, 'Certification to contract,' which refers to the process by which a union, certified by the NLRB as a bargaining agent, can enter into a contract with an employer that has been voted on by the union membership. The other choices are incorrect because 'Certification to represent' does not specifically address entering into a contract, 'Bargaining agreement' refers to the actual agreement reached through negotiation, and 'Contract agreement' is redundant, as it simply repeats the term 'contract.'

3. The Hawthorne effect explains that the relationship between people and productivity is enhanced by which of the following?

• A. Special attention
• B. Organizations
• C. Creativity
• D. Groups

Correct answer: A

Rationale: The Hawthorne effect is a term used to describe how people modify their behavior in response to the attention they are receiving rather than the manipulation of variables. Special attention, as mentioned in choice A, is the correct answer because when individuals feel that they are being closely monitored or that special interest is being taken in them, they tend to perform better or change their behavior. Choices B, C, and D are incorrect because the Hawthorne effect specifically focuses on the impact of attention and not on organizational structures, creativity, or group dynamics.

4. A nurse is planning an educational program for a group of older adults at a senior living center. Which of the following recommendations should the nurse include?

• A. You should receive a pneumococcal vaccine when you are 65 years old.
• B. You should receive a shingles vaccine when you are 70 years old.
• C. You should receive a tetanus booster every 5 years.
• D. You should have an eye examination every 2 years.

Correct answer: A

Rationale: The correct answer is A. The CDC recommends a pneumococcal vaccine for all adults aged 65 years and older. This vaccine helps protect against serious pneumococcal disease. Choice B is incorrect as the shingles vaccine is recommended for adults aged 50 years and older, not specifically at 70 years. Choice C is incorrect because a tetanus booster is recommended every 10 years, not every 5 years. Choice D is incorrect as the general recommendation for eye examinations in older adults is annually, not every 2 years.

5. 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.

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