Nursing Elites

1. Which of the following are essential components of strategic planning?

• A. Values
• B. Vision & Mission statements
• C. Reengineering
• D. A & B

Correct answer: D

Rationale: In strategic planning, values and vision and mission statements play crucial roles. Values guide the organization's culture and decision-making processes, while vision and mission statements outline its long-term goals and purpose. Reengineering, on the other hand, is a separate process focused on restructuring business processes for improved performance efficiency. Therefore, the correct components of strategic planning are values and vision and mission statements, making option D the correct answer. Choices A and B are correct because they are directly related to setting the direction and purpose of the organization in a strategic planning process, while choice C, reengineering, is not typically considered a core element of strategic planning.

2. Professionalism has historically been difficult to define. Early definitions of professionalism included which of the following characteristics?

• A. Expertise
• B. Empathy
• C. Ethical and moral values
• D. Honesty

Correct answer: A

Rationale: The correct answer is A: 'Expertise.' Historically, professionalism was defined by one's knowledge and expertise in a particular field. Choices B, C, and D are incorrect because early definitions of professionalism did not focus on qualities like empathy, ethical and moral values, or honesty, but rather on the individual's level of skill and competence in their area of work.

3. A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?

• A. Increase in hematocrit
• B. Increase in respiratory rate
• C. Decrease in heart rate
• D. Decrease in capillary refill time

Correct answer: D

Rationale: The correct answer is D: Decrease in capillary refill time. In a client with fluid volume deficit, improving capillary refill time indicates that the perfusion status is improving due to the increase in fluid volume. Choices A, B, and C are incorrect. An increase in hematocrit may indicate hemoconcentration due to fluid loss, an increase in respiratory rate may suggest respiratory distress, and a decrease in heart rate may not be directly related to fluid volume status.

4. A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?

• A. Pad the client's wrists before applying the restraints.
• B. Evaluate the client's circulation every 8 hours after application.
• C. Secure the restraint ties to the bed's side rails.
• D. Remove the restraints every 4 hours to evaluate the client's status.

Correct answer: C

Rationale: When applying wrist restraints, it is crucial to secure the restraint ties to the bed's side rails to ensure the client's safety and prevent injury. Padding the client's wrists (Choice A) is not a standard practice and may compromise the effectiveness of the restraints. Evaluating the client's circulation (Choice B) is important but should be done more frequently than every 8 hours to ensure prompt detection of any circulation issues. Removing the restraints every 4 hours (Choice D) is unnecessary and may increase the risk of injury or agitation in the client.

5. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: Clients may request a DNR order, but they need to be fully informed of all the ramifications of the decision. Therefore, the health-care provider will consult with the client and family before the order is written.

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