Nursing Elites

1. What is the primary responsibility of a clinical nurse leader (CNL)?

• A. Supervise nursing staff
• B. Coordinate patient care
• C. Develop nursing policies
• D. Implement evidence-based practice

Correct answer: B

Rationale: The main role of a clinical nurse leader (CNL) is to coordinate patient care. While CNLs may oversee aspects of nursing staff, the primary focus is on coordinating patient care to ensure effective treatment and outcomes. Developing nursing policies and implementing evidence-based practice are important aspects of nursing leadership but are not the main role of a CNL.

2. The problem of overrating staff performance is called ___________ .

• A. Recency error
• B. Absolute judgment
• C. Halo error
• D. Leniency error

Correct answer: D

Rationale: The correct answer is D, 'Leniency error.' Leniency error occurs when a manager tends to overrate staff performance, giving higher ratings than deserved. Choice A, 'Recency error,' refers to the tendency to focus only on recent behaviors or events when evaluating performance. Choice B, 'Absolute judgment,' is not directly related to overrating staff performance; it refers to making evaluations without considering the context or comparison points. Choice C, 'Halo error,' involves allowing one positive aspect of an individual to overshadow other factors in performance evaluation, which is different from overrating overall staff performance.

3. Which of the following would be considered an urgent and important issue?

• A. Replacing two staff who were injured while caring for a violent patient
• B. Updating the employee break room with new furniture
• C. Preparing educational packets on self-administration of insulin for patients
• D. Arranging a team-building event for staff members

Correct answer: A

Rationale: The correct answer is A because replacing staff injured while caring for a violent patient is both urgent and important. This issue directly relates to staff safety and patient care, requiring immediate attention. Choice B is not urgent or crucial to patient care. Choice C is important but may not be as urgent as the situation in choice A. Choice D is not as critical as replacing injured staff, making it a less urgent and important issue.

4. In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?

• A. First
• B. Second
• C. Third
• D. Fourth

Correct answer: A

Rationale: The correct answer is A: First. In the grievance process, the initial step involves the nurse talking to the nurse manager to address the issue informally. Subsequently, step two entails filing a written appeal to the director of nursing or designee. Step three involves a formal meeting with the employee, agent, grievance chairperson, nursing administrator, and director of human resources. The final step, step four, is arbitration, which is initiated when no mutually acceptable solutions can be reached by the involved parties. Therefore, the nurse talking to the nurse manager about the disagreement is the first step in the grievance process.

5. A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?

• A. Suction the client's airway.
• B. Instruct the client to perform incentive spirometry every hour.
• C. Assist the client to an upright position.
• D. Humidify the client's supplemental oxygen.

Correct answer: C

Rationale: When a client is experiencing difficulty breathing, the priority intervention is to assist the client to an upright position. This position helps improve ventilation by maximizing lung expansion and promoting better oxygenation. Suctioning the airway may be necessary if there is an obstruction, but repositioning the client is the initial step. Instructing the client to perform incentive spirometry and humidifying oxygen are important interventions but not the first priority in this scenario.

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