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 using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?

• A. Position the client in a side-lying position.
• B. Perform the irrigation using a 20-mL syringe.
• C. Instill 15 mL of irrigation fluid into the catheter with each flush.
• D. Measure and record the amount of irrigant used.

Correct answer: B

Rationale: When irrigating an indwelling urinary catheter, the nurse should use a 20-mL syringe for the procedure. This syringe size helps to provide adequate pressure for effective irrigation. Placing the client in a side-lying position is not necessary for this procedure. Instilling a specific amount of irrigation fluid into the catheter is not mentioned in the scenario. Subtracting the amount of irrigant used from the client's urine output is not a standard practice in catheter irrigation.

3. An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?

• A. One or more of the parties may be able to reconcile their values.
• B. The patient�s point of view is recognized as valuable.
• C. The dilemma involves two or more equally unpleasant choices.
• D. The institution is unable to honor the patient�s request.

Correct answer: D

Rationale: A patient may make a request that is not possible within the institution. When this occurs, a solution may not be possible within the institution and the patient may need to be transferred to a different institution that may be able to honor the request.

4. Which of the following strategies is most effective for improving staff morale?

• A. Increasing workload
• B. Increasing salaries
• C. Providing feedback
• D. Offering incentives

Correct answer: C

Rationale: Providing feedback is the most effective strategy for improving staff morale. Feedback helps employees understand their performance, areas of improvement, and areas of strength, fostering a sense of recognition and growth. Increasing workload (choice A) can lead to burnout and decreased morale. While increasing salaries (choice B) and offering incentives (choice D) can be motivating, they may not address underlying issues or provide the same level of personal development and recognition that feedback offers.

5. What is the main focus of health literacy initiatives?

• A. To promote the use of medical jargon
• B. To improve patient communication skills
• C. To ensure that patients understand their health information
• D. To reduce the use of electronic health records

Correct answer: C

Rationale: The main focus of health literacy initiatives is to ensure that patients understand their health information. By improving patient comprehension, individuals can make informed decisions about their health, leading to better health outcomes. Promoting the use of medical jargon would have the opposite effect, making health information less accessible. Improving patient communication skills is important but not the primary focus of health literacy initiatives. Electronic health records are tools for managing health information and not directly related to the main goal of health literacy initiatives.

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