Nursing Elites

1. A nurse manager is implementing a quality improvement project to reduce the number of methicillin-resistant Staphylococcus aureus (MRSA) infections at the facility. Which of the following actions should the nurse manager take first?

• A. Develop an MRSA protocol for implementation.
• B. Provide educational in-services for staff.
• C. Evaluate outcomes resulting from interventions.
• D. Conduct a chart review to evaluate precipitating factors of clients who develop MRSA.

Correct answer: D

Rationale: Conducting a chart review to evaluate the precipitating factors of clients who develop MRSA is the initial step in reducing these infections. By identifying factors contributing to MRSA infections, the nurse manager can develop targeted interventions. Developing an MRSA protocol (choice A) and providing educational in-services (choice B) would be premature without understanding the specific factors at play. Evaluating outcomes (choice C) should come after implementing interventions based on the findings from the chart review.

2. A patient has a new prescription for allopurinol to treat gout. What should the nurse include in the teaching?

• A. Decrease protein intake
• B. Limit salt intake
• C. Increase fluid intake
• D. Limit alcohol

Correct answer: C

Rationale: Correct answer: Increasing fluid intake is essential when taking allopurinol to prevent kidney stones and aid in uric acid excretion. This helps reduce the risk of developing complications associated with gout. Decreasing protein intake (Choice A) is not directly related to allopurinol therapy. Limiting salt intake (Choice B) and alcohol consumption (Choice D) are important for overall health but are not specific recommendations when taking allopurinol for gout.

3. While working the night shift, a nurse observes a colleague behaving strangely. What is the best course of action?

• A. Ignore the behavior and continue working
• B. Report the behavior to the supervisor
• C. Ask the colleague if everything is okay
• D. Discuss the behavior with other colleagues

Correct answer: B

Rationale: When a nurse observes a colleague behaving strangely, the best course of action is to report the behavior to the supervisor. Unusual behavior by a healthcare professional could compromise patient safety and should be addressed promptly. Ignoring the behavior (Choice A) could potentially lead to negative outcomes for patients. Asking the colleague directly (Choice C) may not be appropriate if the behavior poses a risk. Discussing the behavior with other colleagues (Choice D) may not directly address the issue and could lead to gossip rather than a resolution.

4. A nurse manager is preparing to complete staff performance appraisals. Which of the following principles should the nurse manager consider when completing the appraisals?

• A. Performance appraisals should be written in measurable terms
• B. Appraisal objectives should be applicable to staff at every level
• C. Performance appraisals should be based on the nurse manager's preferences
• D. Completed appraisals should be approved by a provider

Correct answer: A

Rationale: Corrected Rationale: Performance appraisals should indeed be written in measurable terms to ensure objective evaluations based on specific outcomes achieved. This allows for a clear assessment of staff performance. Choice B is incorrect because appraisal objectives should be tailored to each staff member's role and responsibilities, not necessarily applicable at every level. Choice C is incorrect as performance appraisals should be objective and based on predefined criteria, not solely on the nurse manager's preferences. Choice D is incorrect as completed appraisals usually require approval from higher-level management or HR, not necessarily a provider.

5. How should a healthcare provider respond to a patient who is exhibiting signs of acute myocardial infarction (AMI)?

• A. Calling for emergency assistance immediately
• B. Administering nitroglycerin as prescribed
• C. Monitoring the patient's cardiac rhythm
• D. Administering oxygen and preparing for ECG

Correct answer: A

Rationale: When a patient is exhibiting signs of acute myocardial infarction (AMI), the priority action is to call for emergency assistance immediately. This ensures that the patient receives prompt and appropriate care, including interventions such as administering oxygen, nitroglycerin, and monitoring cardiac rhythm. Administering nitroglycerin should only be done if prescribed by a healthcare provider after assessment and confirmation of AMI. Monitoring the patient's cardiac rhythm is important but not the initial action needed in this critical situation. Administering oxygen and preparing for an ECG are important interventions but should follow the immediate step of calling for emergency assistance.

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