Nursing Elites

1. After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?

• A. Recency error
• B. Leniency error
• C. Halo error
• D. Absolute judgment

Correct answer: A

Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.

2. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision-makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the ethical decision-making process, after identifying the decision-makers involved, the next step is typically planning. During the planning stage, the RN will consider the available options, weigh the ethical principles involved, and develop a course of action to address the ethical dilemma. Choice A, Assessment, involves gathering information and data about the situation. Choice B, Diagnosis, involves analyzing the gathered information to identify the ethical issue. Choice D, Implementation, comes after planning and involves putting the chosen course of action into practice.

3. Cultural diversity presents an important challenge to nurse managers due to which of the following?

• A. A nursing shortage exists
• B. Staff nurses are not trained to be culturally sensitive
• C. 80% of nursing staff comes from one or more minority groups
• D. The increase in cultural diversity is seen both in the patient population and the nursing staff

Correct answer: D

Rationale: Cultural diversity presents an important challenge to nurse managers due to the increase in cultural diversity seen both in the patient population and the nursing staff. This challenge requires nurse managers to ensure that their nursing staff can effectively communicate and provide culturally competent care to patients from diverse backgrounds. Choice A is incorrect because it does not directly relate to the impact of cultural diversity. Choice B is incorrect as it focuses on the training of staff nurses rather than the overall challenge of managing cultural diversity. Choice C is incorrect as the percentage of nursing staff from minority groups, while important, is not the primary reason cultural diversity poses a challenge to nurse managers.

4. After correcting the IVF infusion rate, what should be the next step in the client's care?

• A. Notify family
• B. Discipline the previous nurse
• C. Complete an incident report
• D. Obtain legal consultation

Correct answer: C

Rationale: The correct next step in the client's care after correcting the IVF infusion rate is to complete an incident report. This report is crucial for documenting the event, identifying the root cause of the error, and implementing measures to prevent similar incidents in the future. Notifying the family, disciplining the previous nurse, and obtaining legal consultation are not immediate priorities in this situation. Family notification may be necessary later but ensuring patient safety and proper documentation come first. Disciplining the previous nurse should be handled through the appropriate professional channels, not as an immediate response to the incident. Legal consultation may be needed in some cases but is not the initial step required after correcting the error and ensuring the client's safety.

5. Which agency reviews whether an organization meets its own criteria for staffing?

• A. American Nurses Association (ANA)
• B. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
• C. Patient Classification Systems (PCSs)
• D. Nursing Care Hours (NCHs)

Correct answer: B

Rationale: The correct answer is the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This agency specifies that the right number of competent staff should be provided to meet client's needs. Choices A, C, and D are incorrect as they do not focus on the review of staffing criteria within an organization. The American Nurses Association (ANA) is an organization that supports nurses, Patient Classification Systems (PCSs) are tools used for patient classification, and Nursing Care Hours (NCHs) are related to the number of care hours provided.

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