Nursing Elites

1. Which of the following is an essential element of a quality improvement (QI) program?

• A. Blame and punishment
• B. Employee satisfaction
• C. Continual monitoring
• D. Strict adherence to policies

Correct answer: C

Rationale: The essential element of a quality improvement (QI) program is continual monitoring. Continual monitoring allows for the ongoing assessment of processes, identification of areas for improvement, and tracking of progress. Option A, 'Blame and punishment,' is incorrect as QI programs focus on systemic issues rather than individual blame. Option B, 'Employee satisfaction,' while important for organizational culture, is not an essential element of QI programs. Option D, 'Strict adherence to policies,' is valuable but not the core essential element, which is continual monitoring to drive improvement.

2. In determining a way to make shift change more effective for the nurse and the client, a hospital implemented a course of action. After a week of implementation, the decision was deemed inappropriate. What step of Roger's diffusion of innovations is this?

• A. Confirmation
• B. Implementation
• C. Knowledge
• D. Persuasion

Correct answer: A

Rationale: The correct answer is A: Confirmation. In the diffusion of innovations theory by Rogers, the confirmation stage seeks reinforcement of the action taken. In this scenario, after implementing the course of action regarding shift changes, the decision was reviewed and found inappropriate, aligning with the confirmation phase. Choice B, 'Implementation,' refers to putting the plan into action, which had already been done. Choice C, 'Knowledge,' pertains to becoming aware of the innovation, not evaluating its effectiveness. Choice D, 'Persuasion,' involves efforts to influence individuals to adopt the innovation, not verifying its appropriateness.

3. Which of the following best describes the concept of total quality management (TQM)?

• A. Top-down management
• B. Employee-centered approach
• C. Continuous improvement
• D. Quality control

Correct answer: C

Rationale: The correct answer is C: Continuous improvement. Total quality management (TQM) focuses on continuously improving all aspects of healthcare delivery to enhance patient care, safety, and overall quality. Choice A, 'Top-down management,' does not capture the essence of TQM, which involves involvement at all levels of an organization. Choice B, 'Employee-centered approach,' while important, is not the defining characteristic of TQM. Choice D, 'Quality control,' is a component of TQM but does not fully encompass its comprehensive approach to quality improvement.

4. Which of the following is an example of a clinical decision support system (CDSS)?

• A. Electronic health record (EHR)
• B. Barcode medication administration
• C. Smart infusion pumps
• D. Automated drug dispensing system

Correct answer: C

Rationale: The correct answer is C, smart infusion pumps. Smart infusion pumps are an example of a clinical decision support system (CDSS) as they help ensure accurate medication delivery by providing alerts and dosage calculations. Choice A, electronic health record (EHR), is not a CDSS but rather a digital version of a patient's paper chart. Choice B, barcode medication administration, involves scanning barcodes to verify medication administration but is not a CDSS. Choice D, automated drug dispensing system, automates the medication dispensing process but is not specifically a CDSS.

5. After working at your job for 10 months and feeling unable to tolerate the tension and stress between staff nurses and the laissez-faire nurse manager who is not a leader, what is the best course of action?

• A. Submit a resignation and leave within 30 days.
• B. Complain to staff about the nurse manager.
• C. Seek another position within the healthcare organization and apply for a transfer.
• D. Inform the chief nursing officer that you are leaving and explain your dissatisfaction with the lack of leadership.

Correct answer: C

Rationale: In this situation, it is best to seek another position within the healthcare organization and apply for a transfer. Making professional decisions should involve careful evaluation and consideration. It is important to align personal values with the organizational culture. By seeking advice from a mentor or counselor, you can gain valuable insights and consider different perspectives. Resigning abruptly, complaining to staff, or informing the chief nursing officer without exploring other options may not be the most effective or professional approach in this scenario.

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