Nursing Elites

1. All of the following are essential components of supervision EXCEPT:

• A. All tasks to be delegated or supervised are within the nurse's scope of practice
• B. The necessary tasks require repeated assessments
• C. The nurse has adequate time to develop staff assignments
• D. Policies have been developed that govern nursing practice

Correct answer: B

Rationale: Supervision in nursing requires key components to ensure effective management. Tasks to be delegated or supervised must align with the nurse's scope of practice to maintain safety and quality care. Adequate time for staff assignment development is essential for efficient workflow. Policies governing nursing practice provide a framework for safe and standardized care. However, the statement 'The necessary tasks require repeated assessments' is not an essential component of supervision. Tasks should be clear, achievable, and not necessitate repeated assessments, as this would impede delegation and efficient completion. Repeated assessments may indicate unclear task delegation or inadequate initial assessment, which should be avoided in effective supervision.

2. Mary T. was admitted to a nursing home on May 1st. On July 4th, she was diagnosed with a skin infection. This infection is considered a ________________ infection.

• A. nosocomial
• B. systemic
• C. resident flora
• D. resident aura

Correct answer: A

Rationale: The correct answer is 'nosocomial.' A nosocomial infection is defined as one that is not present upon admission to a healthcare facility but instead occurs during the patient's stay. In this case, since Mary was diagnosed with a skin infection after being admitted to the nursing home, it is considered a nosocomial infection. Nosocomial infections are a significant concern in healthcare settings, and infection control measures are in place to prevent their spread. Choices B, C, and D are incorrect. 'Systemic' refers to a condition affecting the entire body, not specific to a healthcare setting. 'Resident flora' and 'resident aura' are not commonly used terms in healthcare and do not relate to infections acquired in healthcare facilities.

3. Mr. Y had surgery two days ago and is recovering on the surgical unit of the hospital. Just before lunch, he develops chest pain and difficulties with breathing. His respiratory rate is 32/minute, his temperature is 100.8°F, and he has rales on auscultation. Which of the following nursing interventions is most appropriate in this situation?

• A. Place the client in the Trendelenburg position
• B. Contact the physician for an order for antibiotics
• C. Administer oxygen therapy
• D. Decrease his IV rate

Correct answer: C

Rationale: Chest pain, dyspnea, tachypnea, mild fever, and rales or crackles on auscultation in a client who had surgery 2 days ago may be indicative of a pulmonary embolism. The nurse should administer oxygen to address his breathing and assist him to a comfortable position to facilitate better oxygenation before contacting the physician. Placing the client in the Trendelenburg position is not recommended in this situation as it may worsen a potential pulmonary embolism by increasing venous return. Contacting the physician for antibiotics is not the priority as the immediate concern is addressing the breathing difficulty. Decreasing the IV rate is not indicated in this situation where the client is experiencing respiratory distress and needs oxygen therapy.

4. Which example best describes a nurse who exhibits moral courage?

• A. A nurse feels angry when a parent refuses important treatment for his child.
• B. A nurse considers seeking help for depression when she feels she cannot meet the needs of her clients in the oncology unit.
• C. A nurse contacts a physician for further orders when he fails to order comfort measures for a client with a terminal illness.
• D. A nurse is frustrated when the laboratory is slow in responding to an order for a stat blood glucose.

Correct answer: C

Rationale: Moral courage involves taking action to do what is right, even when there might be negative consequences. The nurse who contacted a physician for further orders acted as a client advocate to seek help, even though she may have faced consequences such as lost time, decreased productivity, or criticism from the physician. Choices A, B, and D do not directly involve advocating for a client's needs or challenging a situation that goes against ethical standards. Feeling angry, seeking help for personal issues, or being frustrated with work processes do not necessarily demonstrate moral courage in the context of nursing practice.

5. What does an anti-kickback statute prevent?

• A. It prevents healthcare workers from providing food or hosting parties to celebrate special occasions at work.
• B. It promotes thorough and complete documentation when a client becomes injured.
• C. It forbids giving or accepting gifts to promote or provide referrals for certain services.
• D. It prevents physicians from ordering treatments that may require nursing care beyond the usual amount.

Correct answer: C

Rationale: An anti-kickback statute aims to prevent healthcare providers, clients, consultants, or related organizations from giving or accepting gifts to reward others for referrals of certain services. Choice A is incorrect because providing food or hosting parties at work is not the primary focus of anti-kickback statutes. Choice B is incorrect as it pertains more to documentation practices rather than gift-giving. Choice D is incorrect as it refers to the scope of physician orders and nursing care, not gift exchanges for referrals. The correct answer, as stated, aligns with the purpose of anti-kickback statutes to prevent improper incentives in healthcare relationships.

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