Nursing Elites

1. A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?

• A. ''I had a bowel movement, but I was able to save the urine.''
• B. ''I have a specimen in the bathroom from about 30 minutes ago.''
• C. ''I drink a lot, so I will fill up the bottle and complete the test quickly.''
• D. ''I flushed what I urinated at 7:00 a.m. and have saved all urine since.''

Correct answer: C

Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.

2. One of the most useful tools to determine reasons for turnover is:

• A. Questioning.
• B. Surveys.
• C. Employee forums.
• D. Telephone calls.

Correct answer: B

Rationale: Surveys are one of the most effective tools to determine reasons for turnover because they allow employees to provide feedback anonymously, leading to more truthful responses. While questioning can be part of the process, surveys provide a structured and standardized way to collect data. Employee forums may not always elicit honest responses due to peer pressure or fear of repercussions. Telephone calls may not reach all employees and do not guarantee anonymity, potentially leading to biased or incomplete information.

3. 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:

4. The process by which registered nurses assess and judge the performance of peers against some predetermined standard is called:

• A. Group evaluation.
• B. Peer review.
• C. Forced distribution evaluation.
• D. Essay evaluation.

Correct answer: B

Rationale: The correct answer is B: Peer review. Peer review is a process in which professional peers assess and judge the performance of their colleagues against predetermined standards. Essay evaluations involve describing an employee's performance through a detailed written narrative. Forced distribution evaluation is a method where employees are rated based on a fixed distribution, similar to grading on a curve. Group evaluation, on the other hand, involves managers comparing individual and group performance against organizational standards.

5. Which of the following best describes the concept of total quality management (TQM)?

• A. Top-down management
• B. Employee-centered approach
• C. Continuous improvement
• D. Quality control

Correct answer: C

Rationale: The correct answer is C: Continuous improvement. Total quality management (TQM) focuses on continuously improving all aspects of healthcare delivery to enhance patient care, safety, and overall quality. Choice A, 'Top-down management,' does not capture the essence of TQM, which involves involvement at all levels of an organization. Choice B, 'Employee-centered approach,' while important, is not the defining characteristic of TQM. Choice D, 'Quality control,' is a component of TQM but does not fully encompass its comprehensive approach to quality improvement.

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