Nursing Elites

1. What is the primary reason for conducting a performance appraisal?

• A. Providing constructive feedback.
• B. Imposing punishment.
• C. Identifying issues.
• D. Offering coaching.

Correct answer: A

Rationale: The primary reason for conducting a performance appraisal is to provide constructive feedback to employees. This feedback helps employees understand what is expected of them, how well they are performing, and areas where they can improve. Choice B (Imposing punishment) is incorrect because performance appraisals should focus on development rather than punishment. Choice C (Identifying issues) is not the primary reason but can be a secondary outcome of performance appraisals. Choice D (Offering coaching) is related to providing guidance and support, which is a part of the feedback process but not the primary reason for conducting a performance appraisal.

2. After a violent incident, staff needs to discuss what occurred. Several actions need to be taken following the incident:

• A. Debrief the staff and complete incident reports and verify that all staff are safe
• B. Reassure the violent patient that hurting staff when ill is not cause for concern
• C. Avoid any interactions
• D. Standing close to the patient while talking

Correct answer: A

Rationale: Corrected Rationale: After a violent incident, it is crucial to debrief the staff and complete incident reports to document what occurred and ensure proper follow-up actions. Verifying that all staff are safe is essential for their well-being and security. This process allows professionals to assess the situation, learn from it, and be better prepared to handle similar incidents in the future. Choice B is incorrect because reassuring a violent patient that hurting staff is not a cause for concern may diminish the seriousness of the incident. Choice C is incorrect as avoiding interactions does not address the need for proper communication and resolution. Choice D is incorrect as standing close to a patient who has been violent may escalate the situation and compromise safety.

3. Which of the following strategies is most effective for improving staff morale?

• A. Increasing workload
• B. Increasing salaries
• C. Providing feedback
• D. Offering incentives

Correct answer: C

Rationale: Providing feedback is the most effective strategy for improving staff morale. Feedback helps employees understand their performance, areas of improvement, and areas of strength, fostering a sense of recognition and growth. Increasing workload (choice A) can lead to burnout and decreased morale. While increasing salaries (choice B) and offering incentives (choice D) can be motivating, they may not address underlying issues or provide the same level of personal development and recognition that feedback offers.

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

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

5. What is the primary focus of the Institute for Healthcare Improvement (IHI)?

• A. Patient safety
• B. Cost reduction
• C. Healthcare innovation
• D. Research funding

Correct answer: A

Rationale: The primary focus of the Institute for Healthcare Improvement (IHI) is patient safety. IHI is renowned for its efforts in developing and implementing evidence-based practices to enhance patient safety and improve the quality of care in healthcare settings. While cost reduction, healthcare innovation, and research funding are important aspects of healthcare, the core mission of the IHI revolves around prioritizing patient safety. Patient safety involves reducing medical errors, improving care processes, and creating a safer environment for patients, which are all fundamental to the work of the IHI.

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