Nursing Elites

1. A female patient is scheduled for an oral glucose tolerance test. Which information from the patient’s health history is most important for the nurse to communicate to the health care provider?

• A. The patient uses oral contraceptives.
• B. The patient runs several days a week.
• C. The patient has been pregnant three times
• D. The patient has a family history of diabetes

Correct answer: A

Rationale:

2. How can a staff nurse recognize they are experiencing burnout? (EXCEPT)

• A. They are spending more time talking to staff on other units.
• B. Staff is questioning their clinical judgment.
• C. They sleep longer hours, sometimes coming in late to work.
• D. They are drinking alcohol more frequently to relax.

Correct answer: A

Rationale: Recognizing burnout is essential to maintaining quality patient care. Spending more time talking to staff on other units is a common practice and does not necessarily indicate burnout. On the other hand, staff questioning their clinical judgment, sleeping longer hours or coming in late to work, and resorting to alcohol to relax are signs of burnout. These behaviors can impact patient care and indicate the professional is struggling to cope with stressors.

3. After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?

• A. Recency error
• B. Leniency error
• C. Halo error
• D. Absolute judgment

Correct answer: A

Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.

4. 1. Which patient action indicates good understanding of the nurse’s teaching about administration of aspart (NovoLog) insulin?

• A. The patient avoids injecting the insulin into the upper abdominal area
• B. The patient cleans the skin with soap and water before insulin administration.
• C. The patient stores the insulin in the freezer after administering the prescribed dose.
• D. The patient pushes the plunger down while removing the syringe from the injection site

Correct answer: B

Rationale:

5. How will working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims affect staff?

• A. Feelings of extreme overload.
• B. Fear of failure.
• C. A pessimistic sense about the world.
• D. Inability to separate intense work situations from personal situations.

Correct answer: B

Rationale: Working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims can lead to feelings of extreme overload, a pessimistic sense about the world, and an inability to separate intense work situations from personal situations. Fear of failure is not specifically mentioned in the context of the question, so it is the correct answer. The constant noises and intense emotional situations can create tension, stress, and negative reactions among staff. Managers can help by assessing the environment, labeling situations, and debriefing with staff to make them more aware of how stressors impact their behaviors.

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