Nursing Elites

1. In order to minimize or avoid negative outcomes as a result of the violation and disciplinary action, the employee should offer which of the following?

• A. Excuses
• B. Discipline
• C. Suggestions
• D. Rules

Correct answer: C

Rationale: In order to minimize or avoid negative outcomes resulting from a violation and disciplinary action, the employee should offer suggestions. By providing suggestions, the employee demonstrates a willingness to improve and prevent future occurrences. Offering excuses (choice A) may deflect responsibility and not address the issue at hand. Discipline (choice B) is the action taken by the employer, not the employee. Rules (choice D) are guidelines to follow, but in this context, offering suggestions for improvement is more relevant.

2. Which of the following scenarios would be an example of shared governance on a nursing unit?

• A. Staff nurses delegate activities to CNAs.
• B. Procedure manuals are written by a committee of nurse managers.
• C. Staff nurses and CNAs make their own schedules.
• D. A unit manager seeks advice from her supervisor.

Correct answer: C

Rationale: The correct answer is C. Shared governance in a nursing unit involves staff nurses and CNAs having autonomy and decision-making power in aspects like scheduling, which is reflected in them making their own schedules. This scenario aligns with the philosophy of shared governance where nursing practice is best determined by nurses. Choices A, B, and D do not exemplify shared governance as they involve hierarchical delegation, managerial decision-making, and seeking advice from superiors rather than autonomous decision-making by frontline staff.

3. When addressing a policy violation, what is one of the initial steps to take?

• A. Terminate the employee.
• B. Confront the employee.
• C. Discipline the employee immediately.
• D. Determine whether the employee is aware of the policy.

Correct answer: D

Rationale: When addressing a policy violation, one of the initial steps should be to determine whether the employee is aware of the policy. This step allows for clarification, feedback, and potential training if needed. Terminating the employee (Choice A) or disciplining immediately (Choice C) without assessing awareness can lead to unfair treatment and legal issues. Confronting the employee (Choice B) may be necessary but should come after establishing awareness and providing necessary support or education.

4. After a violent incident, staff needs to discuss what occurred. Several actions need to be taken following the incident:

• A. Debrief the staff and complete incident reports and verify that all staff are safe
• B. Reassure the violent patient that hurting staff when ill is not cause for concern
• C. Avoid any interactions
• D. Standing close to the patient while talking

Correct answer: A

Rationale: Corrected Rationale: After a violent incident, it is crucial to debrief the staff and complete incident reports to document what occurred and ensure proper follow-up actions. Verifying that all staff are safe is essential for their well-being and security. This process allows professionals to assess the situation, learn from it, and be better prepared to handle similar incidents in the future. Choice B is incorrect because reassuring a violent patient that hurting staff is not a cause for concern may diminish the seriousness of the incident. Choice C is incorrect as avoiding interactions does not address the need for proper communication and resolution. Choice D is incorrect as standing close to a patient who has been violent may escalate the situation and compromise safety.

5. The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose

• A. washes the puncture site using warm water and soap
• B. chooses a puncture site in the center of the finger pad
• C. hangs the arm down for a minute before puncturing the site
• D. says the result of 120 mg indicates good blood sugar control

Correct answer: B

Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad is not recommended for blood glucose monitoring. The recommended sites are the sides of the fingertips. Option A is correct as washing the puncture site using warm water and soap is a good practice. Option C is also correct as hanging the arm down for a minute can help increase blood flow. Option D is incorrect as a blood sugar level of 120 mg/dL may not necessarily indicate good blood sugar control and needs further interpretation.

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