Nursing Elites

1. A manager has a budget request deadline today at 3:00. He stops his work to answer the phone, check emails as they arrive, and speak with staff who stop by his office. As a result, he misses the deadline. What best describes the cause of missing his deadline?

• A. Goal setting
• B. Organization
• C. Time wasters
• D. Assertiveness

Correct answer: C

Rationale: The best choice that describes the cause of the manager missing his deadline is 'Time wasters.' In this scenario, the manager's focus was diverted by tasks like answering the phone, checking emails, and speaking with staff, which are considered time wasters when they prevent him from meeting his deadline. Choices A, B, and D are incorrect in this context. Goal setting was not the issue as the manager was aware of the deadline; organization did not play a significant role as his tasks were interrupted by external factors, and assertiveness was not the cause of missing the deadline.

2. The staff nurse is caring for the client with total accountability and is in continual communication with the client, the family, the physicians, and other members of the health care team. This type of nursing delivery system is known as:

• A. Total patient care
• B. Qualified nurse case managers
• C. Established critical pathways
• D. Quality management system

Correct answer: A

Rationale: The correct answer is A: Total patient care. Total patient care is the original model of nursing care delivery, in which one RN has complete responsibility for all aspects of care for one or more patients. In this system, the nurse is accountable for the client's care and maintains continuous communication with the client, their family, physicians, and other healthcare team members. Choice B, Qualified nurse case managers, refers to nurses who coordinate care but do not provide direct hands-on patient care. Choice C, Established critical pathways, involves predefined care plans for specific conditions but does not imply direct accountability as in total patient care. Choice D, Quality management system, relates to processes to ensure and enhance the quality of care but is not specifically about the direct provision of patient care.

3. An RN comes upon a serious motor vehicle accident that has just occurred and no first responders are on the scene. One car has been flipped upside down, and she can see the driver still in the car. The RN decides to stop and help. She knows she is protected from civil liability as long as she does which of the following?

• A. Acts in an ordinary, reasonable, and prudent professional manner
• B. Assures that information obtained is not communicated to anyone else
• C. Does not make any verbal comments that could lead to economic harm
• D. Fails to meet the established standards of practice

Correct answer: A

Rationale: The correct answer is A: 'Acts in an ordinary, reasonable, and prudent professional manner.' In emergency situations, healthcare professionals are protected from civil liability as long as they act in a manner that any other reasonable and prudent professional would under similar circumstances. Choice B is incorrect because communication of relevant information is essential for patient care and handover to other healthcare providers. Choice C is incorrect as it pertains to a different issue of preventing economic harm rather than addressing the immediate medical needs of the injured driver. Choice D is incorrect because failing to meet established standards of practice can lead to liability, especially in emergencies where immediate action is required to save lives.

4. What is the primary purpose of a patient-centered medical home (PCMH)?

• A. To coordinate all aspects of patient care
• B. To reduce healthcare costs
• C. To implement the latest clinical guidelines
• D. To provide financial incentives for providers

Correct answer: A

Rationale: The correct answer is A: 'To coordinate all aspects of patient care.' A patient-centered medical home (PCMH) aims to provide comprehensive and continuous care by coordinating various aspects of a patient's healthcare needs. While reducing healthcare costs and implementing clinical guidelines are important goals in healthcare, the primary focus of a PCMH is on enhancing patient care coordination to improve outcomes and patient satisfaction. Providing financial incentives for providers is not the primary purpose of a PCMH, although it can be a component of some models to encourage quality care delivery.

5. If a staff member does not respond to discipline, the manager must ______ employment.

• A. Terminate
• B. Confront
• C. Describe the staff nurse's behavior that violated the policy
• D. Determine the employee's awareness of the policy

Correct answer: A

Rationale: When an employee does not respond to disciplinary measures, termination may be necessary. This is a last resort for managers when other strategies to improve performance have failed. Terminating an employee means ending their employment with the organization. Choices B, C, and D are incorrect as the question specifically asks what action the manager must take when an employee does not respond to discipline. Confronting the employee, describing the behavior, or determining awareness of the policy are steps that may precede termination but are not the final action to be taken.

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