Nursing Elites

1. Penalties should be __________ .

• A. Determining the employee's awareness of the policy
• B. Describing the staff nurse's behavior that violated the policy
• C. Progressive
• D. Confrontation

Correct answer: C

Rationale: Penalties for policy violations should be progressive. This means that the disciplinary actions should escalate based on the severity or frequency of the violation. For minor infractions, like smoking in an unauthorized area, a progressive approach may include oral warnings, written warnings, suspension, and termination if the behavior persists. In contrast, major violations, such as theft, may warrant immediate and severe consequences like suspension or termination. Choices A, B, and D are incorrect as they do not address the concept of progressively escalating penalties based on the violation's severity or recurrence.

2. From a unit perspective, disruptive and violent patient behavior may be distracting to patients and staff. As the nurse manager, you are concerned about: (EXCEPT)

• A. Patient and staff safety.
• B. Team tension.
• C. Fear of disappointment.
• D. Stress levels.

Correct answer: C

Rationale: Disruptive and violent patient behavior can indeed pose challenges on a unit. Concerns as a nurse manager would revolve around patient and staff safety (Choice A) due to the risk of harm, team tension (Choice B) arising from managing such situations, and stress levels (Choice D) of both patients and staff. Fear of disappointment (Choice C) is not a typical concern in this scenario and does not directly relate to the immediate impact of disruptive and violent patient behavior.

3. When looking at the issue surrounding absenteeism, an innovative approach would be:

• A. Rewarding those who do not use days.
• B. Substituting personal days.
• C. Termination.
• D. Disciplinary actions.

Correct answer: B

Rationale: The correct answer is B. Substituting personal days for sick days can be considered an innovative approach to addressing absenteeism as it allows for proper planning by the nurse manager. This approach promotes a proactive and flexible solution that encourages employees to manage their time off more effectively. Choice A, rewarding those who do not use days, may not address the root causes of absenteeism and could create a culture of presenteeism. Choices C and D, termination and disciplinary actions, are punitive measures that do not focus on preventive strategies or address the underlying reasons for absenteeism.

4. How will working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims affect staff?

• A. Feelings of extreme overload.
• B. Fear of failure.
• C. A pessimistic sense about the world.
• D. Inability to separate intense work situations from personal situations.

Correct answer: B

Rationale: Working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims can lead to feelings of extreme overload, a pessimistic sense about the world, and an inability to separate intense work situations from personal situations. Fear of failure is not specifically mentioned in the context of the question, so it is the correct answer. The constant noises and intense emotional situations can create tension, stress, and negative reactions among staff. Managers can help by assessing the environment, labeling situations, and debriefing with staff to make them more aware of how stressors impact their behaviors.

5. A nurse is admitting a new client. Which of the following actions should the nurse take while performing medication reconciliation?

• A. Compare the client's home medications with the provider's prescriptions
• B. Place the client's home medication bottles in a secure location
• C. Call the pharmacy to determine whether the client's medications are available
• D. Verify the client's name on their identification bracelet with the medication administration record

Correct answer: A

Rationale: The correct answer is A. During medication reconciliation, the nurse should compare the client's home medications with the provider's prescriptions to ensure accurate and safe administration. This process helps identify any discrepancies or potential interactions. Choice B is incorrect because placing the client's home medication bottles in a secure location is not part of medication reconciliation. Choice C is incorrect as calling the pharmacy to determine medication availability is not related to reconciling medications. Choice D is incorrect as verifying the client's name on their identification bracelet with the medication administration record is part of the identification process, not medication reconciliation.

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