Nursing Elites

1. Which of the following is an example of a macro-level health policy?

• A. Local health ordinances
• B. State licensing regulations
• C. National healthcare legislation
• D. Institutional policies

Correct answer: C

Rationale: The correct answer is national healthcare legislation. This type of policy operates at a broad level, influencing healthcare delivery and financing across an entire nation. It sets overarching frameworks and regulations that impact various aspects of the healthcare system on a large scale, affecting a wide population rather than specific localities or institutions. Choices A, B, and D are not examples of macro-level health policy. Local health ordinances pertain to specific areas or communities, state licensing regulations focus on a state level, and institutional policies are internal regulations of a particular healthcare facility.

2. Which of the following strategies is most effective for reducing medication errors on a nursing unit?

• A. Increasing the nurse-to-patient ratio
• B. Providing ongoing education on safe medication practices
• C. Using barcoding technology for medication administration
• D. Increasing the use of PRN medications

Correct answer: C

Rationale: The most effective strategy for reducing medication errors on a nursing unit is using barcoding technology for medication administration. Barcoding technology helps to ensure the right medication is given to the right patient in the right dose at the right time. Increasing the nurse-to-patient ratio (choice A) may help in preventing errors due to workload, but it may not address the root cause of medication errors. Providing ongoing education (choice B) is important but may not be as effective as implementing technology to directly prevent errors during administration. Increasing the use of PRN medications (choice D) can actually increase the risk of errors if not carefully monitored and controlled.

3. Your values do not coincide with your colleagues. When you report for your shift on nights and staff are not responding to patient requests for pain medication, you, as the nurse responsible for collecting data about patient quality of care, should:

• A. Explain to the nurse manager that quality problems are because of staff apathy.
• B. Issue a memo to staff to assess patients and document their response to the pain medication.
• C. Explain to staff that improving quality is one of your annual goals and you expect them to follow through.
• D. Schedule meetings to engage with staff to monitor pain management.

Correct answer: D

Rationale: As the nurse responsible for collecting data about patient quality of care, it is important to address the issue of staff not responding to patient requests for pain medication. Scheduling meetings to engage with staff to monitor pain management is the most appropriate course of action in this scenario. By enlisting support from staff, reviewing patient satisfaction data, and quality reports about pain management, you can effectively address the issue and improve patient care. Choices A, B, and C are not as effective as they do not involve actively engaging with staff, reviewing data, and working collaboratively to address the problem.

4. One of the most useful tools to determine reasons for turnover is:

• A. Questioning.
• B. Surveys.
• C. Employee forums.
• D. Telephone calls.

Correct answer: B

Rationale: Surveys are one of the most effective tools to determine reasons for turnover because they allow employees to provide feedback anonymously, leading to more truthful responses. While questioning can be part of the process, surveys provide a structured and standardized way to collect data. Employee forums may not always elicit honest responses due to peer pressure or fear of repercussions. Telephone calls may not reach all employees and do not guarantee anonymity, potentially leading to biased or incomplete information.

5. When utilizing an internal float pool, which of the following pools is most efficient?

• A. Centralized
• B. Flexible
• C. Mixed
• D. Decentralized

Correct answer: A

Rationale: Centralization is the most efficient option when utilizing an internal float pool because it allows for a pool of nurses to be used anywhere in the hospital. In centralized pools, staff members are not limited to working for only one nurse manager or on only one unit, unlike in decentralized pools. Flexible and mixed pools may offer some advantages, but in terms of efficiency and utilization of resources, centralized pools are the most effective choice.

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