Nursing Elites

1. Staff refuse to report unsafe conditions, with unattended entrances throughout the health care facility noted. Unidentified individuals are wandering the unit at night, and you:

• A. Establish expectations.
• B. Demand that they leave immediately.
• C. Ask them to leave.
• D. Observe their behaviors.

Correct answer: A

Rationale: In this scenario, the correct course of action is to establish expectations. By setting clear guidelines and expectations, you can address the issue of unidentified individuals wandering the unit at night in a proactive manner. This approach helps communicate what behaviors are acceptable, ensuring the safety of both staff and patients. Demanding that they leave immediately may not address the root cause of the problem and could escalate the situation. Simply observing their behaviors may not effectively resolve the issue or prevent future incidents. Asking them to leave without first establishing expectations may not prevent similar occurrences in the future.

2. Which of the following types of HMOs (Health Maintenance Organizations) contracts with two or more IPAs (Independent Practice Associations)?

• A. Staff model
• B. Point of service model
• C. Network model
• D. Group model

Correct answer: C

Rationale: The correct answer is C, the Network model. This type of HMO contracts with two or more IPAs. In a Network model, multiple IPAs work together to provide healthcare services to the members. Choice A, the Staff model, involves physicians who are employees of the HMO. Choice B, the Point of Service model, allows members to seek care outside the network at a higher cost. Choice D, the Group model, does not specifically contract with IPAs.

3. A nurse is caring for a client who is scheduled to be transferred to a long-term care facility. The client's family questions the nurse about the reasons for the transfer. Which of the following responses made by the nurse is appropriate?

• A. The transfer of your family member is being done because the provider knows what's best.
• B. Would you like us to discuss the transfer with your family member?
• C. Why are you so concerned about this transfer?
• D. I know how you feel. My parent had to be transferred to a long-term care facility.

Correct answer: A

Rationale: The correct response is A because it provides a professional and reassuring explanation for the transfer, focusing on the expertise of the healthcare provider. Choice B offers to include the family member in the discussion, which may not address their concerns directly. Choice C appears defensive and does not address the family's inquiry. Choice D shifts the focus to the nurse's personal experience, which may not be relevant or helpful to the family seeking information about their own situation.

4. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

5. What is the primary purpose of a nurse staffing committee?

• A. To oversee patient safety initiatives
• B. To develop staffing policies and procedures
• C. To coordinate patient care
• D. To manage nurse recruitment

Correct answer: B

Rationale: The primary purpose of a nurse staffing committee is to develop staffing policies and procedures to ensure adequate nurse-to-patient ratios. By establishing these guidelines, the committee aims to optimize patient care by ensuring appropriate staffing levels, which in turn can enhance patient safety and coordination of care. While overseeing patient safety initiatives and managing nurse recruitment are important aspects of healthcare management, the core function of a nurse staffing committee is to create and implement policies that govern the allocation and distribution of nursing staff to meet patient care needs effectively. Therefore, choices A, C, and D, though relevant to healthcare, do not align with the primary purpose of a nurse staffing committee as outlined in the question.

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