Nursing Elites

1. A manager identifies that he is spending more time than desired on completing repetitive paperwork. Which of the following would be appropriate ways to address this issue? (EXCEPT)

• A. Combining data reports to reduce duplication
• B. Delegating staff evaluations to the staff nurse on the unit with the most experience
• C. Assigning the preliminary draft of the schedule to a subcommittee of staff nurses
• D. Saying no to inappropriate paperwork assignments

Correct answer: B

Rationale: Delegating staff evaluations to a staff nurse, even if experienced, is not appropriate as it falls outside their scope and responsibility. Choices A, C, and D are suitable ways to address the issue of spending excessive time on repetitive paperwork. Combining data reports, assigning the preliminary draft of the schedule to a subcommittee of staff nurses, and saying no to inappropriate paperwork assignments are all effective strategies to streamline processes and reduce managerial workload.

2. Which of the following is a key principle of team nursing?

• A. Decentralized decision making
• B. Centralized decision making
• C. Individual accountability
• D. Shared responsibility

Correct answer: D

Rationale: The correct answer is D: 'Shared responsibility.' Team nursing emphasizes shared responsibility among team members for patient care. This approach promotes collaboration and coordination among healthcare professionals to deliver comprehensive and holistic care. Choices A and B are incorrect because team nursing typically involves collaborative decision-making rather than centralized or decentralized decision-making. Choice C, 'Individual accountability,' does not align with the collaborative nature of team nursing, where responsibility is shared among team members rather than falling solely on individuals.

3. Monitoring the number of times a medication is given utilizing the 'five rights' is an example of which phase of the Six Sigma program?

• A. Measure
• B. Management
• C. Quantitative
• D. Goal

Correct answer: A

Rationale: In the Six Sigma program, the 'Measure' phase focuses on monitoring and measuring processes to ensure they meet the desired standards. This includes tracking the number of times a medication is given correctly using the 'five rights' principle. Therefore, the correct answer is A. Choice B, 'Management,' does not specifically relate to monitoring processes or data collection, so it is not the correct answer. Choice C, 'Quantitative,' refers to the use of numerical data in decision-making, which is a broader concept and not specific to monitoring processes within the Six Sigma framework. Choice D, 'Goal,' is too general and does not capture the specific phase of Six Sigma that involves monitoring and measuring processes.

4. A healthcare professional is caring for a client who has a sodium level of 125 mEq/L (136 to 145 mEq/L). Which of the following findings should the healthcare professional expect?

• A. Positive Chvostek's sign
• B. Bradycardia
• C. Numbness of the extremities
• D. Abdominal cramping

Correct answer: D

Rationale: A sodium level of 125 mEq/L indicates hyponatremia, which can lead to abdominal cramping. Abdominal cramping is a common symptom of hyponatremia due to an imbalance in electrolytes. While other options like Chvostek's sign, bradycardia, and numbness of the extremities can be associated with other electrolyte imbalances, they are not typically seen with low sodium levels. Chvostek's sign is related to hypocalcemia, bradycardia can be seen in hyperkalemia, and numbness of the extremities can be a symptom of hypocalcemia or hypokalemia, but not directly related to hyponatremia.

5. If the nurse and nurse manager did not resolve the situation related to the physician's report about the nurse's performance, what is the length of time allowed for the nurse to submit an appeal?

• A. 10 days
• B. 15 days
• C. 20 days
• D. 30 days

Correct answer: A

Rationale: If the informal discussion between the nurse and nurse manager does not resolve the issue regarding the physician's report on the nurse's performance, the nurse can submit a written appeal within 10 days, according to the healthcare facility policy. This 10-day timeframe ensures a prompt resolution of disputes and maintains clear communication channels within the healthcare setting. Choices B, C, and D are incorrect as they exceed the time limit allowed for the nurse to submit an appeal, which is specified to be 10 days.

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