Nursing Elites

1. To best reduce the potential for risk, what type of atmosphere is needed to be developed?

• A. Nurse-focused
• B. Physician-focused
• C. Family-focused
• D. Patient-focused

Correct answer: D

Rationale: The correct answer is 'Patient-focused.' When aiming to reduce the potential for risk, it is essential to prioritize the needs and well-being of the patients. Creating a patient-focused atmosphere helps ensure that decisions and actions are made with the patients' best interests in mind. Choices A, B, and C are incorrect because while nurses, physicians, and families play essential roles in healthcare, when it comes to reducing risks, the primary focus should be on the patients themselves.

2. A Nurse Manager completes an interruption log and identifies two staff members who take an inordinate amount of time with drop-in issues that are not urgent. What are some methods to address this behavior in an attempt to better manage time? (Select all that apply.)

• A. Designate specific time slots for drop-in visits.
• B. Position the desk chair so it is not facing the hallway.
• C. Communicate with staff about using e-mail for non-urgent matters to improve time management.
• D. When staff members drop in, the manager should stand and remain standing during the conversation.

Correct answer: A

Rationale: Designating specific time slots for drop-in visits helps in managing interruptions effectively by consolidating them into designated periods. This approach allows the Nurse Manager to allocate focused time for addressing these issues without disrupting workflow. Option B, repositioning the desk chair, is not a standard strategy for managing time or interruptions. Option C, promoting the use of e-mail for non-urgent matters, may help in some cases but may not entirely address the behavior of extended drop-in visits. Option D, standing during conversations, may not be practical for longer discussions and does not provide a structured approach to address time management issues.

3. What is the primary reason for conducting a performance appraisal?

• A. Providing constructive feedback.
• B. Imposing punishment.
• C. Identifying issues.
• D. Offering coaching.

Correct answer: A

Rationale: The primary reason for conducting a performance appraisal is to provide constructive feedback to employees. This feedback helps employees understand what is expected of them, how well they are performing, and areas where they can improve. Choice B (Imposing punishment) is incorrect because performance appraisals should focus on development rather than punishment. Choice C (Identifying issues) is not the primary reason but can be a secondary outcome of performance appraisals. Choice D (Offering coaching) is related to providing guidance and support, which is a part of the feedback process but not the primary reason for conducting a performance appraisal.

4. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

• A. Hypotension
• B. Distended neck veins
• C. Slow capillary refill
• D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

5. When is the time to make people think about the routines that have been previously followed and to consider what might be a better plan of action?

• A. Collection of data
• B. Planning
• C. Analyzing data
• D. Identification

Correct answer: B

Rationale: The correct answer is B, 'Planning.' Planning is the phase where individuals reflect on current routines and explore alternative courses of action. This stage involves considering new strategies and approaches, making it the most suitable time to challenge existing norms. Choice A, 'Collection of data,' focuses on gathering information rather than actively reconsidering routines. Choice C, 'Analyzing data,' involves assessing the gathered data rather than proposing new plans. Choice D, 'Identification,' does not specifically address the process of reviewing routines and suggesting improvements, making it less relevant to the question.

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