Nursing Elites

1. What are the key elements essential to the implementation of case management? (Select all that apply.)

• A. Collaborative practice teams
• B. Established critical pathways
• C. Quality management system
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Established critical pathways, collaborative practice teams, and quality management systems are indeed key elements essential to the implementation of case management. Collaborative practice teams allow for multidisciplinary collaboration, established critical pathways help guide patient care, and a quality management system ensures that care provided meets established standards. Choice A, collaborative practice teams, is correct as they are fundamental for effective case management, involving various professionals working together. Choice B, established critical pathways, is also correct as they provide a structured approach to managing patient care. Choice C, quality management system, is correct as it ensures that care is delivered at high standards and continuously monitored for improvement. Therefore, all these elements are crucial for successful case management implementation.

2. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

3. Strategies to advance your career and opportunities available in your first job can coexist. Identify factors that will help you prioritize these opportunities to fulfill your goals. (Select all that apply.)

• A. Self-actualization and assessing your values and your lifestyle.
• B. Determine where you can grow and develop professionally.
• C. Your ability to work as a team member.
• D. Reflect on your long-term career aspirations.

Correct answer: A

Rationale: The correct answer is A. Self-actualization involves assessing your values and lifestyle, which is crucial for prioritizing opportunities that align with your goals. This process helps you understand yourself better and make informed decisions to advance your career. Choice B is incorrect because focusing solely on salary may not necessarily lead to career growth and fulfillment. Choice C is about teamwork skills, which are important but not directly related to prioritizing career opportunities. Choice D is about seeking opinions from others, which may not always align with your personal goals and aspirations.

4. A group of physicians comes into conflict with the nursing staff of a unit over when AM vital signs are recorded. What type of technique might be used that respects the professionalism of both parties?

• A. Accommodating
• B. Collaboration
• C. Avoiding
• D. Competing

Correct answer: B

Rationale: In this scenario, the most appropriate technique to use is collaboration. Collaboration involves working together with mutual attention to the problem, utilizing the talents of all parties involved. This approach respects the professionalism of both physicians and nursing staff by valuing their input and expertise. Choice A, accommodating, involves giving in to the other party's concerns, which may not fully address the conflict. Choice C, avoiding, suggests ignoring or sidestepping the issue, which does not promote a resolution. Choice D, competing, involves pursuing one's own concerns at the expense of the other party's, leading to a win-lose situation, which is not conducive to resolving conflicts in a professional setting.

5. An environment that rewards good __________ is the goal in a work environment.

• A. Performance
• B. Turnover
• C. Strategies
• D. Stress

Correct answer: A

Rationale: An environment that rewards good performance is the goal in a work environment as it promotes productivity and motivation among employees. Rewarding performance leads to improved outcomes and helps in achieving organizational objectives. Choice B, 'Turnover,' is incorrect as turnover refers to the rate at which employees leave an organization, and it is not a goal to be rewarded. Choice C, 'Strategies,' does not directly relate to rewarding good behavior but rather focuses on plans or approaches to achieve goals. Choice D, 'Stress,' is not something that should be rewarded in a work environment; instead, it should be managed and reduced to promote employee well-being.

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