Nursing Elites

1. The staff nurse is caring for the client with total accountability and is in continual communication with the client, the family, the physicians, and other members of the health care team. This type of nursing delivery system is known as:

• A. Total patient care
• B. Qualified nurse case managers
• C. Established critical pathways
• D. Quality management system

Correct answer: A

Rationale: The correct answer is A: Total patient care. Total patient care is the original model of nursing care delivery, in which one RN has complete responsibility for all aspects of care for one or more patients. In this system, the nurse is accountable for the client's care and maintains continuous communication with the client, their family, physicians, and other healthcare team members. Choice B, Qualified nurse case managers, refers to nurses who coordinate care but do not provide direct hands-on patient care. Choice C, Established critical pathways, involves predefined care plans for specific conditions but does not imply direct accountability as in total patient care. Choice D, Quality management system, relates to processes to ensure and enhance the quality of care but is not specifically about the direct provision of patient care.

2. Which of the following is considered voluntary turnover?

• A. Desire to leave
• B. Termination
• C. Forced resignation
• D. Floating

Correct answer: A

Rationale: The correct answer is A, 'Desire to leave.' Voluntary turnover occurs when an employee chooses to leave the organization. In this case, it is a direct function of the nurse's desire to leave. Termination and forced resignation are involuntary processes where the decision is made by the employer, not the employee. 'Floating' refers to the reassignment of a nurse to a unit different from their usual work unit and is not directly related to turnover.

3. Which of the following describes the concept of ratification?

• A. Contract administration
• B. Contract passage
• C. Contract denial
• D. Contract reorganization

Correct answer: B

Rationale: The correct answer is B: 'Contract passage.' Ratification refers to the approval or confirmation of a contract by a simple majority of members who vote to pass it. Choice A, 'Contract administration,' does not accurately describe ratification as it focuses more on the management of contracts rather than their approval. Choice C, 'Contract denial,' is incorrect as ratification implies acceptance or approval, not denial. Choice D, 'Contract reorganization,' is also incorrect as ratification does not involve restructuring or reorganizing a contract, but rather confirming its validity.

4. A Staff Nurse submits a six-week notice of resignation. The Nurse Manager prepares a request to immediately post the position and begin interviews. This action is best described as which of the following?

• A. Delegation
• B. A time-waster
• C. Reactive management
• D. Proactive management

Correct answer: D

Rationale: The correct answer is D, Proactive management. Proactive management involves taking steps to prevent issues from occurring rather than just reacting to them. In this scenario, the Nurse Manager is being proactive by preparing to fill the position before the Staff Nurse leaves, thereby preventing short staffing. Choices A, B, and C are incorrect. Delegation refers to assigning tasks to others, not preparing to fill a vacant position. Calling it a time-waster is subjective and not reflective of the manager's proactive approach. Reactive management would involve waiting until the Nurse leaves and then trying to fill the position, causing short staffing.

5. Which agency reviews whether an organization meets its own criteria for staffing?

• A. American Nurses Association (ANA)
• B. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
• C. Patient Classification Systems (PCSs)
• D. Nursing Care Hours (NCHs)

Correct answer: B

Rationale: The correct answer is the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This agency specifies that the right number of competent staff should be provided to meet client's needs. Choices A, C, and D are incorrect as they do not focus on the review of staffing criteria within an organization. The American Nurses Association (ANA) is an organization that supports nurses, Patient Classification Systems (PCSs) are tools used for patient classification, and Nursing Care Hours (NCHs) are related to the number of care hours provided.

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