Nursing Elites

1. Monitoring the number of times a medication is given utilizing the 'five rights' is an example of which phase of the Six Sigma program?

• A. Measure
• B. Management
• C. Quantitative
• D. Goal

Correct answer: A

Rationale: In the Six Sigma program, the 'Measure' phase focuses on monitoring and measuring processes to ensure they meet the desired standards. This includes tracking the number of times a medication is given correctly using the 'five rights' principle. Therefore, the correct answer is A. Choice B, 'Management,' does not specifically relate to monitoring processes or data collection, so it is not the correct answer. Choice C, 'Quantitative,' refers to the use of numerical data in decision-making, which is a broader concept and not specific to monitoring processes within the Six Sigma framework. Choice D, 'Goal,' is too general and does not capture the specific phase of Six Sigma that involves monitoring and measuring processes.

2. A registered nurse (RN) who usually uses public transportation has not renewed her driver’s license. During a recent car trip with a friend, she took over driving when her friend became tired. Which of the following is true?

• A. She has acted in a professional manner.
• B. She may lose her RN license for driving without a license.
• C. She should renew her driver’s license as soon as possible.
• D. Under the circumstances, she will not be faulted for driving without a license.

Correct answer: B

Rationale: Driving without a license is deemed an unprofessional and illegal behavior for which a nurse may lose his or her license.

3. In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?

• A. First
• B. Second
• C. Third
• D. Fourth

Correct answer: A

Rationale: The correct answer is A: First. In the grievance process, the initial step involves the nurse talking to the nurse manager to address the issue informally. Subsequently, step two entails filing a written appeal to the director of nursing or designee. Step three involves a formal meeting with the employee, agent, grievance chairperson, nursing administrator, and director of human resources. The final step, step four, is arbitration, which is initiated when no mutually acceptable solutions can be reached by the involved parties. Therefore, the nurse talking to the nurse manager about the disagreement is the first step in the grievance process.

4. During a physical assessment of adult clients, which of the following techniques should the nurse use?

• A. Use the Face, Legs, Activity, Cry, and Consolability (FLACC) pain rating scale for a client experiencing pain.
• B. Palpate the client's abdomen before auscultating bowel sounds.
• C. Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.
• D. Obtain an apical heart rate by auscultating at the third intercostal space to the left of the sternum.

Correct answer: B

Rationale: When performing a physical assessment, it is essential to palpate the client's abdomen before auscultating bowel sounds. This sequence helps prevent altering bowel sound results due to the pressure applied during palpation. Choice A is incorrect because the FLACC pain rating scale is typically used for nonverbal or pediatric clients, not adults. Choice C is incorrect because the bladder of the blood pressure cuff should surround about 80% of the client's arm circumference, not the bladder of the cuff itself. Choice D is incorrect because to obtain an apical heart rate, auscultation should be done at the fifth intercostal space at the midclavicular line, not at the third intercostal space to the left of the sternum.

5. A nurse manager is preparing the budget for the year. The budgeted amounts have been set without regard to changes that may occur during the year. What type of budget is the manager preparing?

• A. Fixed budget
• B. Zero-based budget
• C. Variable budget
• D. Operating budget

Correct answer: A

Rationale: The correct answer is A: Fixed budget. A fixed budget is one where the budgeted amounts are set without considering changes that may occur during the year. This type of budget is based on the assumption that the business environment will remain stable. Choice B, Zero-based budget, involves setting the budget at zero and justifying all expenses. Choice C, Variable budget, adjusts based on changes in activity levels. Choice D, Operating budget, is a comprehensive projection of all revenue and expenses for the upcoming period.

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