Nursing Elites

1. Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)

• A. Notify the nursing supervisor.
• B. Notify security.
• C. Have them check patients to verify safety.
• D. Ask construction workers to be responsible.

Correct answer: D

Rationale: When construction is ongoing in a healthcare setting, it is essential to address safety concerns promptly. While it is crucial to notify the nursing supervisor and security to manage potential risks, having staff check patients for safety is also a valid precautionary measure. However, asking construction workers to be responsible is not a proper action to address the safety concerns posed by the equipment. Construction workers are professionals responsible for their tasks; it is the healthcare facility's responsibility to ensure patient and staff safety in such situations.

2. Which of the following strategies is most effective for reducing medication errors on a nursing unit?

• A. Increasing the nurse-to-patient ratio
• B. Providing ongoing education on safe medication practices
• C. Using barcoding technology for medication administration
• D. Increasing the use of PRN medications

Correct answer: C

Rationale: The most effective strategy for reducing medication errors on a nursing unit is using barcoding technology for medication administration. Barcoding technology helps to ensure the right medication is given to the right patient in the right dose at the right time. Increasing the nurse-to-patient ratio (choice A) may help in preventing errors due to workload, but it may not address the root cause of medication errors. Providing ongoing education (choice B) is important but may not be as effective as implementing technology to directly prevent errors during administration. Increasing the use of PRN medications (choice D) can actually increase the risk of errors if not carefully monitored and controlled.

3. Staff are sometimes injured when a patient or visitor becomes agitated. If a staff member reports an injury, the following actions should take place: (EXCEPT)

• A. Notify security.
• B. Complete an incident report.
• C. Notify the nursing supervisor.
• D. Ensure that staff has been examined.

Correct answer: B

Rationale: When a staff member reports an injury resulting from an agitated patient or visitor, several actions should be taken. These actions include notifying security to ensure safety, notifying the nursing supervisor for appropriate follow-up, and ensuring that the injured staff member has been examined to assess the extent of the injury. Completing an incident report is not the correct action to exclude because documenting the incident is crucial for legal and healthcare purposes. Incident reports provide a detailed account of what occurred, which is essential for investigations, insurance claims, and improving safety protocols. Therefore, all other options are necessary steps to take when a staff member reports an injury, making completing an incident report the correct answer for exclusion.

4. A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?

• A. Perceived conflict
• B. Disruptive conflict
• C. Competitive conflict
• D. Felt conflict

Correct answer: B

Rationale: The correct answer is 'Disruptive conflict.' In disruptive conflict, the parties involved are engaged in activities to reduce, defeat, or eliminate the opponent. In this scenario, the resident and the nurse are engaging in behaviors that disrupt their professional relationship by intentionally ignoring pages and making excessive retaliatory calls. Perceived conflict refers to a situation where one or more parties believe that a conflict exists, competitive conflict involves striving to achieve personal goals at the expense of others, and felt conflict refers to the emotional involvement in a conflict situation.

5. The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select ONE that does not apply.)

• A. Expected length of stay
• B. Assigned staff healthcare provider
• C. Patient outcomes
• D. Medical diagnosis

Correct answer: B

Rationale: Critical pathways are designed to outline the expected sequence and timing of interventions to achieve optimal patient outcomes for a specific medical condition. Components such as the expected length of stay, patient outcomes, and medical diagnosis are crucial in developing a critical pathway for congestive heart failure. However, the assigned staff healthcare provider is not typically a fixed component of a critical pathway as it may vary based on staffing schedules and rotations. Therefore, the assigned staff healthcare provider is the component that does not apply.

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