Nursing Elites

1. How can a staff nurse recognize they are experiencing burnout? (EXCEPT)

• A. They are spending more time talking to staff on other units.
• B. Staff is questioning their clinical judgment.
• C. They sleep longer hours, sometimes coming in late to work.
• D. They are drinking alcohol more frequently to relax.

Correct answer: A

Rationale: Recognizing burnout is essential to maintaining quality patient care. Spending more time talking to staff on other units is a common practice and does not necessarily indicate burnout. On the other hand, staff questioning their clinical judgment, sleeping longer hours or coming in late to work, and resorting to alcohol to relax are signs of burnout. These behaviors can impact patient care and indicate the professional is struggling to cope with stressors.

2. The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia) through a restricted access medication program. What is most important for the nurse to report immediately to the health care provider?

• A. The patient's blood pressure is 154/92.
• B. The patient has a history of emphysema
• C. The patient's blood glucose is 86 mg/dL.
• D. The patient has chest pressure when walking

Correct answer: D

Rationale: Chest pressure while walking may indicate heart-related issues such as angina or a heart attack. Rosiglitazone (Avandia) has been associated with increased risks of cardiovascular events like heart failure. Given these risks, chest pressure is an urgent symptom that must be reported immediately to prevent potentially life-threatening complications.

3. A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?

• A. ''I had a bowel movement, but I was able to save the urine.''
• B. ''I have a specimen in the bathroom from about 30 minutes ago.''
• C. ''I drink a lot, so I will fill up the bottle and complete the test quickly.''
• D. ''I flushed what I urinated at 7:00 a.m. and have saved all urine since.''

Correct answer: C

Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.

4. The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions would be which of the following strategies?

• A. Verifying through feedback
• B. Follow-up communication
• C. Getting positive attention
• D. Knowing the context of the instruction

Correct answer: A

Rationale: Asking the subordinate to repeat the instructions is a strategy known as verifying through feedback. This approach ensures that the receiver has understood the request correctly. Choice B, 'Follow-up communication,' refers to checking in after the initial communication, not necessarily asking for repetition. Choice C, 'Getting positive attention,' is unrelated to confirming understanding. Choice D, 'Knowing the context of the instruction,' deals with understanding the background or reasons behind the instructions, not confirming comprehension.

5. Which of the following best describes the concept of just culture in a healthcare organization?

• A. A culture of blaming individuals for mistakes
• B. A culture of encouraging reporting and learning from errors
• C. A culture of punishing individuals for errors
• D. A culture of ignoring errors

Correct answer: B

Rationale: Just culture in a healthcare organization promotes a blame-free environment where individuals are encouraged to report errors and focus on learning from them to improve patient safety and quality of care. Choice A is incorrect as just culture does not involve blaming individuals. Choice C is incorrect as it goes against the principles of just culture by advocating for punishment rather than learning. Choice D is incorrect as just culture aims to address errors constructively rather than ignore them.

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