Nursing Elites

1. A nurse is caring for a client who has a nasogastric (NG) tube and is receiving intermittent feedings through an open system. Which of the following actions should the nurse take first?

• A. Make sure the enteral formula is at room temperature.
• B. Wipe the top of the formula can with alcohol.
• C. Rinse the feeding bag with water between feedings.
• D. Tell the client to keep the head of the bed elevated at least 30�

Correct answer: B

Rationale:

2. Horizontal violence may be observed among staff interactions and causes stress among staff. To minimize stress associated with such interactions, nurses can: (Select all that apply.)

• A. Encourage venting as a way to express feelings.
• B. Take control of the situation by being assertive.
• C. Ignore staff who are volatile.
• D. Avoid interactions with angry staff.

Correct answer: B

Rationale: To minimize stress associated with horizontal violence among staff interactions, nurses should take control of the situation by being assertive. Being assertive allows nurses to address the issues causing stress in a constructive and professional manner. Encouraging venting without addressing the underlying problems may not resolve the situation effectively. Ignoring staff who are volatile can escalate the issue further, and avoiding interactions with angry staff does not address the root cause of the problem. Therefore, being assertive and addressing the situation directly is the most effective approach to minimize stress and promote a healthy work environment.

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. A nurse manager wants to implement a new policy on the unit. What is the first step in the change process according to Lewin's Change Theory?

• A. Unfreeze the system
• B. Move the system to a new level
• C. Refreeze the system
• D. Evaluate the system

Correct answer: A

Rationale: The correct answer is A: 'Unfreeze the system.' According to Lewin's Change Theory, unfreezing the system is the initial step in the change process. This step involves preparing the organization for change by creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Choice B, 'Move the system to a new level,' is incorrect as it does not align with the first step of unfreezing. Choice C, 'Refreeze the system,' is incorrect as it pertains to the final stage of solidifying the change, not the first step. Choice D, 'Evaluate the system,' is incorrect as evaluation typically occurs after the change has been implemented, not at the beginning of the change process.

5. What is the main focus of the Six Sigma methodology in healthcare?

• A. Reducing healthcare costs
• B. Improving patient satisfaction
• C. Enhancing clinical decision making
• D. Increasing healthcare access

Correct answer: C

Rationale: The main focus of the Six Sigma methodology in healthcare is enhancing clinical decision making through data-driven approaches. By using statistical methods and quality improvement tools, Six Sigma aims to reduce errors, improve processes, and enhance overall decision-making in healthcare settings. While reducing healthcare costs and improving patient satisfaction are important goals, they are not the primary focus of Six Sigma in healthcare. Increasing healthcare access is also a valuable objective but not the main focus of the Six Sigma methodology.

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