Nursing Elites

1. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: A DNR order can be written after the health-care provider has discussed it with the client and family.

2. A Manager decides that setting goals will assist her in better utilizing her time. Which of the following are true regarding goal setting in the Manager role?

• A. Goals need to be measurable, realistic, and achievable to be effective.
• B. Writing goals will increase the stress level of the Manager.
• C. Goals should be vague, so they are more likely to be met.
• D. Setting goals is a time waster in the Manager role.

Correct answer: A

Rationale: Setting goals is beneficial for a Manager as they provide direction and save time. Therefore, goals need to be measurable, realistic, and achievable to be effective. Choice B is incorrect as writing goals does not increase stress but rather helps in time management. Choice C is incorrect because vague goals can lead to confusion and lack of clarity. Choice D is also incorrect as setting goals is a productive activity that aids in time management and achievement.

3. A nurse manager wants to implement a new policy on the unit. What is the first step in the change process according to Lewin's Change Theory?

• A. Unfreeze the system
• B. Move the system to a new level
• C. Refreeze the system
• D. Evaluate the system

Correct answer: A

Rationale: The correct answer is A: 'Unfreeze the system.' According to Lewin's Change Theory, unfreezing the system is the initial step in the change process. This step involves preparing the organization for change by creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Choice B, 'Move the system to a new level,' is incorrect as it does not align with the first step of unfreezing. Choice C, 'Refreeze the system,' is incorrect as it pertains to the final stage of solidifying the change, not the first step. Choice D, 'Evaluate the system,' is incorrect as evaluation typically occurs after the change has been implemented, not at the beginning of the change process.

4. A client with frequent tonic-clonic seizures is being admitted. What action should the nurse add to the client's plan of care?

• A. Ensure blankets are placed on all four sides of the bed.
• B. Refrain from using restraints during seizure activity.
• C. Position the client laterally during seizure activity.
• D. Have a tongue depressor available at the client's bedside.

Correct answer: D

Rationale: The correct action the nurse should add to the client's plan of care is to have a tongue depressor available at the client's bedside. This is important during a seizure to prevent the client from biting their tongue. Placing the client laterally helps maintain a clear airway and prevents aspiration, making choice C a good practice during seizure activity. Using restraints during a seizure can cause injuries and should be avoided, making choice B incorrect. Wrapping blankets around all four sides of the bed is unnecessary for seizure management and does not contribute to the client's safety during a seizure, making choice A incorrect.

5. Which of the following is the preferable alternative to firing an employee?

• A. Voluntary resignation
• B. Training
• C. Confrontation
• D. Coaching

Correct answer: A

Rationale: The preferable alternative to firing an employee is voluntary resignation. When an employee voluntarily resigns, it allows them to leave on their terms, maintaining their dignity and possibly avoiding negative consequences associated with being fired. Training, confrontation, and coaching are not alternatives to firing but rather methods that can be used to address performance or behavior issues before resorting to termination.

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