Nursing Elites

1. The ANA recommends that nursing in the health care organization change its focus. This requires a shift from a technical model to which of the following?

• A. Professional
• B. Industrial
• C. Random
• D. Organized

Correct answer: A

Rationale: The correct answer is A: Professional. The American Nurses Association (ANA) recommends shifting the focus in healthcare organizations from a technical model to a professional model. This change emphasizes the level of nurse competence required to provide quality care. Choice B, Industrial, is incorrect as it does not align with the focus on professionalism in nursing. Choice C, Random, is unrelated to the context of the question. Choice D, Organized, while a positive attribute, is not the specific focus recommended by the ANA for nursing in healthcare organizations.

2. Which of the following is an example of a sentinel event?

• A. A patient fall with no injury
• B. A medication error that results in no harm
• C. A patient suicide while in a healthcare facility
• D. A near miss incident

Correct answer: C

Rationale: The correct answer is C, a patient suicide while in a healthcare facility. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury. Choices A, B, and D do not meet the criteria for sentinel events as described by The Joint Commission, as they do not involve death or serious harm to the patient.

3. After receiving change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who has a hemoglobin A1C of 12%
• B. 23-year-old with type 1 diabetes who has a blood glucose of 40 mg/dL
• C. 40-year-old who is pregnant and has an oral glucose tolerance test result of 202 mg/dL
• D. 50-year-old who uses exenatide (Byetta) and is complaining of acute abdominal pain

Correct answer: B

Rationale: The correct answer is B because the patient with a blood glucose level of 40 mg/dL (hypoglycemia) needs immediate attention. Hypoglycemia is an emergency situation that requires prompt intervention to prevent adverse effects such as seizures or loss of consciousness. Assessing and managing this patient first is crucial to prevent further deterioration. Choices A, C, and D do not present immediate life-threatening situations requiring urgent intervention like severe hypoglycemia does. While a high hemoglobin A1C level (choice A), an abnormal oral glucose tolerance test result (choice C), and acute abdominal pain (choice D) are important issues, they do not pose an immediate threat to the patient's life compared to severe hypoglycemia.

4. Your nurse manager talks with you once per week to determine how you are adjusting to your role as a new nurse. She asks if you feel that you are able to provide good care to your patients, whether you are becoming familiar with the electronic health record, and whether your preceptor is encouraging your independence. This manager is demonstrating:

• A. An intrusive style.
• B. An effort to understand if you are coping with the demands.
• C. An attempt to intimidate.
• D. An authoritarian style.

Correct answer: B

Rationale: The correct answer is B. The nurse manager is showing an effort to understand if you are coping with the demands of your new role as a nurse. This approach demonstrates empathy and concern for your well-being and professional development. Choices A, C, and D are incorrect because there is no indication of intrusion, intimidation, or authoritarian behavior in the manager's actions. Instead, the manager is engaging in supportive and constructive communication to help you adjust and grow in your new position.

5. When matching a job with an experienced RN, what is the first step in the selection process?

• A. Job analysis
• B. Selection techniques
• C. Methods of recruiting
• D. Assurance of legal requirements

Correct answer: A

Rationale: The correct answer is A, job analysis. Job analysis is the first step in the selection process as it involves gathering information about the duties, responsibilities, necessary skills, outcomes, and work environment of a particular job. This information is crucial in creating an accurate job description and specification that will guide the recruitment and selection process. Choices B, C, and D are incorrect because while selection techniques, methods of recruiting, and legal requirements are important aspects of the selection process, they come after the job analysis has been completed.

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