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. After a violent incident, staff needs to discuss what occurred. Several actions need to be taken following the incident:

• A. Debrief the staff and complete incident reports and verify that all staff are safe
• B. Reassure the violent patient that hurting staff when ill is not cause for concern
• C. Avoid any interactions
• D. Standing close to the patient while talking

Correct answer: A

Rationale: Corrected Rationale: After a violent incident, it is crucial to debrief the staff and complete incident reports to document what occurred and ensure proper follow-up actions. Verifying that all staff are safe is essential for their well-being and security. This process allows professionals to assess the situation, learn from it, and be better prepared to handle similar incidents in the future. Choice B is incorrect because reassuring a violent patient that hurting staff is not a cause for concern may diminish the seriousness of the incident. Choice C is incorrect as avoiding interactions does not address the need for proper communication and resolution. Choice D is incorrect as standing close to a patient who has been violent may escalate the situation and compromise safety.

3. How does decision making differ from problem solving?

• A. Decision making always involves selecting from a set of alternatives.
• B. Problem solving always involves selecting one of several alternatives.
• C. Problem solving never involves decision making.
• D. Decision making always involves solving a problem.

Correct answer: A

Rationale: The correct answer is A because decision making always involves selecting from a set of alternatives, while problem solving involves diagnosing a problem. Option B is incorrect as problem solving involves diagnosing a problem rather than selecting one of several alternatives. Option C is incorrect because decision making is often a part of problem-solving processes. Option D is incorrect as decision making may involve selecting from alternatives, not necessarily solving a problem.

4. An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN�s friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying?

• A. Fidelity
• B. Confidentiality
• C. Veracity
• D. Accountability

Correct answer: B

Rationale: The principle of confidentiality requires nurses to hold healthcare information and anything patients tell them in the strictest confidence.

5. Which of the following is the correct definition of 'chain of command'?

• A. The hierarchy of authority and responsibility
• B. Relationship without authority
• C. Activity directed through linear authority
• D. The tendency for people to perform as expected

Correct answer: A

Rationale: The correct definition of 'chain of command' is the hierarchy of authority and responsibility. This term refers to the order in which authority and power in an organization are wielded and delegated from top management to every employee at every level. Choice B, 'Relationship without authority,' is incorrect because the chain of command specifically involves authority and responsibility. Choice C, 'Activity directed through linear authority,' is not a precise definition of the chain of command, as it does not encompass the full scope of authority and hierarchy. Choice D, 'The tendency for people to perform as expected,' is unrelated to the concept of the chain of command.

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