Nursing Elites

1. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

2. Which of the following is a key component of patient-centered care?

• A. Provider-centered decision making
• B. Timely discharge
• C. Respect for patient preferences
• D. Focusing on clinical outcomes

Correct answer: C

Rationale: The correct answer is C: Respect for patient preferences. Patient-centered care focuses on involving patients in their care decisions and respecting their preferences. Choice A, provider-centered decision making, goes against the concept of patient-centered care as it prioritizes the provider over the patient. Timely discharge, choice B, is important but not a defining component of patient-centered care. Focusing on clinical outcomes, choice D, is essential in healthcare but does not solely represent patient-centered care, which is more about personalized care and involving patients in decision-making.

3. Which of the following conditions would be well suited to the use of a nursing critical pathway?

• A. Foreign object in the ear
• B. Fever of unknown origin
• C. Hip replacement surgery
• D. Bacterial infection acquired in a foreign country

Correct answer: C

Rationale: A critical pathway is designed to track a patient's progress through a specific timeline, including assessments, interventions, treatments, and outcomes. Hip replacement surgery is well suited for a nursing critical pathway because it has a defined timeline with specific interventions and treatments aimed at achieving optimal functioning. Choices A, B, and D do not typically follow a structured timeline with predetermined interventions and outcomes, making them less suitable for a critical pathway.

4. What is the main purpose of a utilization review?

• A. Evaluate patient outcomes
• B. Ensure compliance with regulations
• C. Reduce hospital readmissions
• D. Assess financial impact

Correct answer: A

Rationale: The main purpose of a utilization review is to evaluate patient outcomes and ensure that patients receive appropriate care based on medical necessity and quality standards. While ensuring compliance with regulations, reducing hospital readmissions, and assessing financial impact are important aspects of healthcare management, the primary goal of utilization review is to focus on the quality and effectiveness of patient care.

5. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?

• A. Teach the patient about administering regular insulin.
• B. Schedule the patient for a fasting blood glucose level.
• C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
• D. Provide teaching about an increased risk for fetal problems with gestational diabetes.

Correct answer: B

Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.

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