Nursing Elites

1. A nurse witnesses a colleague administering the wrong IV solution to a client. What should the nurse do first?

• A. Complete an incident report.
• B. Ask the colleague if they intend to report the error.
• C. Call the healthcare provider to notify them of the error.
• D. Notify the supervisor about the situation.

Correct answer: B

Rationale: The correct first step for the nurse to take in this situation is to ask the colleague if they intend to report the error. It is important to address the error promptly and directly with the colleague involved to ensure that the appropriate actions are taken to correct the mistake and prevent harm to the client. Completing an incident report, calling the healthcare provider, or notifying the supervisor can be done after discussing the error with the colleague. Immediate communication with the colleague directly involved in the error is crucial to address the situation effectively.

2. A health care provider asks the nurse who is caring for a client with a new colostomy to ask the hospital's stoma nurse to visit the client. What is the nurse's responsibility?

• A. Contact the stoma nurse immediately.
• B. Educate the client on stoma care.
• C. Assess the stoma site for complications.
• D. Arrange for follow-up visits with the stoma nurse.

Correct answer: B

Rationale: The correct answer is B: 'Educate the client on stoma care.' The nurse's primary responsibility in this scenario is to provide education to the client on stoma care. This empowers the client to take care of their colostomy effectively. While it is important to involve the stoma nurse for specialized care, the immediate action required from the nurse is client education. Choice A is incorrect as the immediate action is not to contact the stoma nurse but to educate the client first. Choice C is not the nurse's initial responsibility unless there are obvious complications. Choice D is premature as arranging follow-up visits should come after the client has been educated and initial care has been provided.

3. A nurse manager is teaching a group of employees about standards for Quality and Safety Education for Nurses (QSEN). Which of the following statements by an employee should the nurse manager identify as an example of the QSEN concept of quality improvement?

• A. We should start tracking how soon clients are discharged after laparoscopic versus open surgery.
• B. We should involve our clients' partners in care planning as much as possible.
• C. We should be sure to log out of the computers immediately following documentation.
• D. We should provide change-of-shift report as a team, including the assistive personnel who assisted with care.

Correct answer: B

Rationale: Involving partners in care planning is a quality improvement strategy that aligns with QSEN principles. This choice reflects patient-centered care and collaboration, which are essential elements of quality improvement. Choices A, C, and D do not directly relate to quality improvement concepts. Tracking discharge times, logging out of computers, and providing change-of-shift reports are important practices but not specifically focused on quality improvement.

4. When preparing to give a report during a shift change, what information is most critical to communicate?

• A. Include a full family medical history.
• B. Focus on changes in the patient's condition.
• C. Summarize the patient's treatment plan.
• D. Provide updates on the patient's lab results.

Correct answer: B

Rationale: During a shift change report, the most critical information to communicate is focusing on changes in the patient's condition. This helps ensure that all healthcare providers are aware of any significant developments or deterioration in the patient's health status, allowing for timely and appropriate interventions. Choices A, C, and D are not as crucial during a shift report. While a full family medical history and treatment plan are important aspects of patient care, they are not the primary focus during a shift change report. Providing updates on lab results may be important but may not be as time-sensitive or immediately impactful as changes in the patient's condition.

5. A client is preparing for a surgical procedure but refuses to remove religious jewelry. What is the best course of action?

• A. Proceed with surgery and document the refusal.
• B. Ask the client for permission to secure the jewelry.
• C. Remove the jewelry and store it safely.
• D. Postpone the surgery until the jewelry is removed.

Correct answer: B

Rationale: The best course of action is to ask the client for permission to secure the jewelry. This respects the client's religious beliefs while also ensuring that the jewelry does not interfere during the surgical procedure. Proceeding with surgery without addressing the presence of the jewelry can lead to complications or distress for the client. Removing the jewelry without consent or postponing the surgery solely due to the presence of religious jewelry are not appropriate actions in this situation.

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