Nursing Elites

1. A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?

• A. Pad the client's wrists before applying the restraints.
• B. Evaluate the client's circulation every 8 hours after application.
• C. Secure the restraint ties to the bed's side rails.
• D. Remove the restraints every 4 hours to evaluate the client's status.

Correct answer: C

Rationale: When applying wrist restraints, it is crucial to secure the restraint ties to the bed's side rails to ensure the client's safety and prevent injury. Padding the client's wrists (Choice A) is not a standard practice and may compromise the effectiveness of the restraints. Evaluating the client's circulation (Choice B) is important but should be done more frequently than every 8 hours to ensure prompt detection of any circulation issues. Removing the restraints every 4 hours (Choice D) is unnecessary and may increase the risk of injury or agitation in the client.

2. The staff nurse delegates AM care for two patients to the UAP (Unlicensed Assistive Person). What principle of delegation is the nurse following?

• A. Delegation requires a situation with clearly defined superiors.
• B. Delegation can only exist with a subordinate.
• C. Delegation is a tool used by various healthcare professionals.
• D. You can delegate only those tasks.

Correct answer: D

Rationale: The correct answer is D: 'You can delegate only those tasks.' Delegation in nursing involves transferring responsibility for the performance of a task while retaining accountability for the outcome. The principle of delegation does not require a situation with clearly defined superiors (choice A). Delegation can exist not only with a subordinate but also with colleagues or other healthcare team members (choice B). Delegation is not exclusive to nurses and is a tool used by various healthcare professionals (choice C). Therefore, the best choice is D as it accurately reflects the principle of delegation in nursing.

3. Which of the following actions best demonstrates effective delegation by a nurse manager?

• A. Retaining all tasks
• B. Assigning tasks without supervision
• C. Delegating tasks and providing oversight
• D. Avoiding delegation

Correct answer: C

Rationale: The correct answer is C: Delegating tasks and providing oversight. Effective delegation by a nurse manager involves appropriately assigning tasks to others while also ensuring proper supervision and follow-up. This allows the nurse manager to distribute workload efficiently while maintaining accountability and quality of care. Choices A and D are incorrect as retaining all tasks or avoiding delegation can lead to burnout, inefficiency, and lack of skill development among team members. Choice B is incorrect as assigning tasks without supervision may result in errors, lack of clarity, and potential patient safety issues.

4. One of the most important driving forces behind health care policy changes is which of the following?

• A. New technology
• B. Outsourcing of services
• C. Emerging role of nurse practitioners
• D. Ability to pay for health care

Correct answer: D

Rationale: The correct answer is D, 'Ability to pay for health care.' One of the primary factors influencing health care policy changes is the financial aspect, as the ability to afford healthcare services affects access, quality, and equity. While new technology, outsourcing of services, and the emerging role of nurse practitioners may also impact health care policies, the fundamental driver often revolves around individuals' and societies' financial capacity to pay for healthcare.

5. Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)

• A. Notify the nursing supervisor.
• B. Notify security.
• C. Have them check patients to verify safety.
• D. Ask construction workers to be responsible.

Correct answer: D

Rationale: When construction is ongoing in a healthcare setting, it is essential to address safety concerns promptly. While it is crucial to notify the nursing supervisor and security to manage potential risks, having staff check patients for safety is also a valid precautionary measure. However, asking construction workers to be responsible is not a proper action to address the safety concerns posed by the equipment. Construction workers are professionals responsible for their tasks; it is the healthcare facility's responsibility to ensure patient and staff safety in such situations.

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