Nursing Elites

1. Quality management and benchmarking are two approaches used to improve the quality of care. The major difference between these two approaches is which of the following?

• A. Quality management is not useful in the outpatient setting
• B. Benchmarking compares outcomes in a variety of settings and disciplines
• C. Quality management is used only in the primary care setting
• D. Benchmarking looks only at outcomes specific to nursing

Correct answer: B

Rationale: The major difference between quality management and benchmarking is that benchmarking compares outcomes in a variety of settings and disciplines. Choice A is incorrect because quality management can be applied in both inpatient and outpatient settings. Choice C is incorrect as quality management is not limited to primary care and can be implemented across various healthcare settings. Choice D is incorrect as benchmarking does not solely focus on nursing outcomes but rather compares outcomes across different disciplines and settings.

2. There are several elements in recruiting strategies. Which of the following is one of those elements?

• A. Not selling
• B. How to sell
• C. When to sell
• D. What to sell

Correct answer: B

Rationale: The correct answer is B: 'How to sell.' In any recruiting strategy, key elements include where to look, how to look, when to look, and finally, how to sell. 'How to sell' refers to the tactics and techniques used to attract and persuade potential candidates. Choices A, C, and D are incorrect because 'Not selling,' 'When to sell,' and 'What to sell' are not primary elements in recruiting strategies.

3. After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?

• A. Recency error
• B. Leniency error
• C. Halo error
• D. Absolute judgment

Correct answer: A

Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.

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. What is a common barrier to effective delegation?

• A. Lack of trust in team members
• B. Lack of communication
• C. Inadequate training
• D. Lack of resources

Correct answer: A

Rationale: One of the common barriers to effective delegation is a lack of trust in team members. Delegating tasks involves entrusting responsibilities to others, and without trust in the team members' capabilities, the delegator may struggle to effectively assign tasks. Trust is essential for successful delegation as it allows for empowerment and accountability within the team. While lack of communication is crucial for effective delegation, the lack of trust has a more profound impact as it directly affects the ability to delegate tasks. Inadequate training and lack of resources, although important factors, are not as fundamental as trust in team members when it comes to effective delegation.

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