Nursing Elites

1. Which of the following clients would most likely be selected for case management?

• A. An adolescent with a gunshot wound who is in the ER.
• B. A young adult with a fractured pelvis.
• C. An elderly client awaiting a hip replacement.
• D. A 41-year-old client admitted for outpatient tonsillectomy.

Correct answer: C

Rationale: The correct answer is C, an elderly client awaiting a hip replacement. This choice is most likely selected for case management because hip replacements are common surgical procedures with high volume in hospitals, making it appropriate for case management. Choices A, B, and D involve acute care conditions but do not typically require the same level of coordination and management that a hip replacement case would. Therefore, they are less likely to be selected for case management.

2. What is the primary focus of a performance appraisal for nursing staff?

• A. To identify areas for salary increases
• B. To evaluate overall job performance
• C. To provide feedback on clinical skills
• D. To determine eligibility for promotions

Correct answer: C

Rationale: The primary focus of a performance appraisal for nursing staff is to provide feedback on clinical skills, identify areas for improvement, and support professional development. While salary increases, overall job performance evaluation, and promotions may be factors considered during a performance appraisal, the primary goal is to assess and enhance clinical skills to ensure high-quality patient care.

3. 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.

4. Selye's stress theory explains that a person stressed for long periods of time will:

• A. Face exhaustion and be more susceptible to illnesses.
• B. Become fatigued and become stronger.
• C. Become more assertive.
• D. Safety needs.

Correct answer: A

Rationale: Selye's stress theory posits that individuals experiencing prolonged stress are likely to face exhaustion and become more susceptible to illnesses. This is because the body's response to chronic stress can lead to physical and psychological depletion, increasing the risk of health problems. Choice B is incorrect as becoming stronger is not a typical outcome of prolonged stress according to Selye's theory. Choice C, becoming more assertive, is not directly related to the physical implications of chronic stress. Choice D, safety needs, is unrelated to Selye's stress theory and does not reflect the expected outcomes of prolonged stress.

5. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation the RN should include in the reminders is to 'Only use approved abbreviations.' Using shortcuts in documentation (choice A) may lead to errors or omissions, affecting the credibility of documentation. Documentation should be objective (choice C) rather than subjective to ensure accuracy and legal credibility. It is essential to document care promptly after providing it (choice D) to maintain the accuracy and completeness of patient records, but using approved abbreviations is a more specific recommendation to enhance legal credibility.

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