Nursing Elites

1. Which of the following conditions would be well suited to the use of a nursing critical pathway?

• A. Foreign object in the ear
• B. Fever of unknown origin
• C. Hip replacement surgery
• D. Bacterial infection acquired in a foreign country

Correct answer: C

Rationale: A critical pathway is designed to track a patient's progress through a specific timeline, including assessments, interventions, treatments, and outcomes. Hip replacement surgery is well suited for a nursing critical pathway because it has a defined timeline with specific interventions and treatments aimed at achieving optimal functioning. Choices A, B, and D do not typically follow a structured timeline with predetermined interventions and outcomes, making them less suitable for a critical pathway.

2. When trying to facilitate change in the staff, it is necessary to build trust and recognize the need for change. This type of action is known as which of the following, according to Lewin's Force-Field Model?

• A. Moving the system to a new level
• B. Unfreezing the system
• C. Refreezing the system
• D. Institutionalization

Correct answer: B

Rationale: The correct answer is 'Unfreezing the system.' In Lewin's Force-Field Model, unfreezing is the stage where the existing equilibrium is disrupted to motivate participants and prepare them for change. Building trust and recognizing the need for change are essential components of this stage. Choice A, 'Moving the system to a new level,' does not specifically address the initial stage of disruption. Choice C, 'Refreezing the system,' comes after change has been implemented, not before. Choice D, 'Institutionalization,' refers to the stage where the change becomes the new norm, which is different from unfreezing.

3. Which of the following best describes the role of a nurse preceptor?

• A. Supervisor of all nursing staff
• B. Mentor and educator for new nurses
• C. Director of nursing services
• D. Coordinator of patient care

Correct answer: B

Rationale: The correct answer is B: 'Mentor and educator for new nurses.' A nurse preceptor plays a crucial role in mentoring and educating new nurses. They provide guidance, support, and practical knowledge to help new nurses transition smoothly into their roles. While preceptors may have supervisory responsibilities during the orientation period, their primary focus is on supporting the professional development of new nurses, rather than supervising all nursing staff, directing nursing services, or coordinating patient care. Choice A is incorrect because a nurse preceptor does not supervise all nursing staff but focuses on new nurses. Choice C is incorrect as the role of a director of nursing services involves overall management and leadership of nursing services. Choice D is incorrect as a coordinator of patient care is responsible for organizing patient care activities, not specifically focused on mentoring new nurses.

4. What is the primary goal of evidence-based practice (EBP)?

• A. Reduce healthcare costs
• B. Improve patient outcomes
• C. Enhance clinical decision making
• D. Ensure patient safety

Correct answer: C

Rationale: The primary goal of evidence-based practice (EBP) is to enhance clinical decision making by integrating the best available evidence with clinical expertise and patient values. While improving patient outcomes is a significant result of EBP, the ultimate aim is to ensure that healthcare decisions are based on the most current, relevant, and reliable evidence. While reducing healthcare costs and ensuring patient safety are important in healthcare, they are not the primary goals of evidence-based practice.

5. 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.

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