Nursing Elites

1. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation the RN should include in the reminders is to 'Only use approved abbreviations.' Using shortcuts in documentation (choice A) may lead to errors or omissions, affecting the credibility of documentation. Documentation should be objective (choice C) rather than subjective to ensure accuracy and legal credibility. It is essential to document care promptly after providing it (choice D) to maintain the accuracy and completeness of patient records, but using approved abbreviations is a more specific recommendation to enhance legal credibility.

2. A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about

• A. self-monitoring of blood glucose
• B. using low doses of regular insulin
• C. lifestyle changes to lower blood glucose
• D. effects of oral hypoglycemic medications

Correct answer: C

Rationale: When a patient has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L), indicating prediabetes, the initial approach is focused on lifestyle modifications to lower blood glucose levels. These changes may include dietary adjustments, increased physical activity, and weight management. Self-monitoring of blood glucose, insulin therapy, and oral hypoglycemic medications are not typically the first-line interventions for patients with prediabetes. Educating the patient about lifestyle changes to lower blood glucose is the most appropriate action at this stage.

3. Which of the following factors contributes to conflicts in professional nursing today?

• A. Some nurses who had planned to retire but find themselves forced to continue working because of the current economic situation
• B. Balancing state practice acts, codes of ethics, and standards of practice
• C. Advances in technology
• D. Multiple generations in the workforce

Correct answer: D

Rationale: The presence of multiple generations in the nursing workforce today with diverse viewpoints and work styles can lead to conflicts. This diversity in perspectives and approaches may result in disagreements on how tasks should be done or how patient care should be managed. Option A refers to economic factors impacting individual nurses rather than conflicts within the profession. Option B is related to compliance and ethical considerations, not conflicts. Option C, advances in technology, may influence nursing practices but is not directly linked to conflicts among professionals.

4. A nurse manager asks the staff to submit written suggestions for a change in policy. The group would then vote on the different suggestions. What type of decision-making technique did the nurse manager use?

• A. Statistical aggregation
• B. Nominal group technique
• C. Brainstorming
• D. Delphi

Correct answer: B

Rationale: The nurse manager used the nominal group technique. This technique involves group members submitting written suggestions, followed by a voting process. Statistical aggregation involves analyzing numerical data, not suggestions. Brainstorming focuses on generating creative ideas collectively, without a structured voting process. Delphi technique involves reaching a consensus through a series of questionnaires or surveys, without a direct voting process.

5. What are the key elements essential to the implementation of case management? (Select all that apply.)

• A. Collaborative practice teams
• B. Established critical pathways
• C. Quality management system
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Established critical pathways, collaborative practice teams, and quality management systems are indeed key elements essential to the implementation of case management. Collaborative practice teams allow for multidisciplinary collaboration, established critical pathways help guide patient care, and a quality management system ensures that care provided meets established standards. Choice A, collaborative practice teams, is correct as they are fundamental for effective case management, involving various professionals working together. Choice B, established critical pathways, is also correct as they provide a structured approach to managing patient care. Choice C, quality management system, is correct as it ensures that care is delivered at high standards and continuously monitored for improvement. Therefore, all these elements are crucial for successful case management implementation.

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