Nursing Elites

1. A nurse is comparing the rate of medication errors on the medical unit to the rate from a medical unit in a magnet hospital. Which of the following quality improvement methods is the nurse using?

• A. Structure audit
• B. Benchmarking
• C. Risk benefit analysis
• D. Root cause analysis

Correct answer: B

Rationale: The correct answer is B: Benchmarking. Benchmarking involves comparing performance metrics with those from other units or institutions, which is exactly what the nurse is doing by comparing the rate of medication errors on their medical unit to the rate from a medical unit in a magnet hospital. Choice A, Structure audit, is not relevant to this scenario as it focuses on assessing the physical, organizational, or procedural structures in a healthcare setting. Choice C, Risk benefit analysis, involves weighing the potential risks and benefits of a particular course of action, not comparing performance metrics. Choice D, Root cause analysis, is a method used to identify the underlying causes of problems or adverse events, not to compare performance metrics between units.

2. A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first?

• A. Remove the restraints from the client's wrists
• B. Review the chart for nonrestraint alternatives for agitation
• C. Speak with the AP about the incident
• D. Inform the unit manager of the incident

Correct answer: A

Rationale: The correct action for the nurse to take first is to remove the restraints from the client's wrists. Restraints should not be applied without a prescription due to the risk of harm to the client. Removing the restraints promptly is a priority to ensure the client's safety. Reviewing nonrestraint alternatives, speaking with the AP, and informing the unit manager can follow after ensuring the client's immediate safety by removing the restraints.

3. Which of the following is true regarding the Affordable Care Act?

• A. The Affordable Care Act addressed issues of interest to nursing without controversy.
• B. The Affordable Care Act addressed issues of mandatory overtime, incivility, and high workloads for nurses.
• C. The Affordable Care Act provided a new patient-centered model for health care.
• D. The Affordable Care Act attempted to address many of the issues of interest to nursing, but came with much controversy.

Correct answer: D

Rationale: The correct answer is D. The Affordable Care Act attempted to address many issues relevant to nursing, such as mandatory overtime, incivility, and high workloads, but it faced significant controversy. Choice A is incorrect as the act did not address nursing issues without controversy. Choice B is incorrect as it inaccurately lists the issues the act addressed. Choice C is incorrect as it does not fully capture the controversy surrounding the Affordable Care Act.

4. Your pediatric patient weighs 15.8 kg. How many pounds does this child weigh?

• A. 36 pounds
• B. 33.6 pounds
• C. 35 pounds
• D. 34.8 pounds

Correct answer: D

Rationale: To convert 15.8 kg to pounds, you multiply by the conversion factor of 2.20462. So, 15.8 kg * 2.20462 = 34.8 pounds. Therefore, the child weighs 34.8 pounds. Choice A is incorrect as it is higher than the correct answer. Choice B is incorrect as it is lower than the correct answer. Choice C is incorrect as it rounds down the conversion result, leading to an inaccurate weight measurement.

5. Nurses on an inpatient care unit are working to help reduce unit costs. Which of the following actions is appropriate to include in the cost-containment plan?

• A. Store opened bottles of normal saline in a refrigerator for up to 48 hours.
• B. Return unused supplies from the bedside to the unit's supply stock.
• C. Wait to dispose of sharps containers until they are completely full.
• D. Use clean gloves rather than sterile gloves for colostomy care.

Correct answer: D

Rationale: Using clean gloves rather than sterile gloves for colostomy care is a cost-effective measure without compromising care quality. This choice helps in reducing costs without compromising patient safety. Storing opened bottles of normal saline in a refrigerator for up to 48 hours (Choice A) may lead to contamination risks. Returning unused supplies to the unit's supply stock (Choice B) can be inefficient and lead to potential waste. Waiting to dispose of sharps containers until they are completely full (Choice C) may pose safety hazards and not directly impact cost savings.

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