Nursing Elites

1. Which of the following theories explains that organizations are made up of intertwined links and diversified choices that generate unanticipated consequences?

• A. Contingency theory
• B. Closed system theory
• C. Open system theory
• D. Chaos theory

Correct answer: D

Rationale: The chaos theory explains that organizations are made up of intertwined links and diversified choices that generate unanticipated consequences. Choice A, Contingency theory, focuses on how organizations adapt to their environment. Choice B, Closed system theory, suggests that organizations are self-contained and do not interact with their environment. Choice C, Open system theory, emphasizes that organizations interact with their environment but does not specifically address intertwined links and diversified choices generating unanticipated consequences.

2. Which of the following is an example of a sentinel event in healthcare?

• A. A patient falling in the hospital without injury
• B. A near-miss medication error
• C. An unexpected patient death unrelated to the natural course of illness
• D. A patient developing an infection during a hospital stay

Correct answer: C

Rationale: The correct answer is C. A sentinel event in healthcare is an unexpected patient death unrelated to the natural course of illness. These events are serious occurrences that warrant immediate investigation and response to prevent their recurrence and ensure patient safety. Choices A, B, and D do not fit the definition of a sentinel event. While choices A, B, and D are serious incidents, they do not involve an unexpected patient death unrelated to the natural course of illness, which is the defining characteristic of a sentinel event.

3. A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?

• A. Wear an N95 respirator when giving direct care to the client.
• B. Place the client in a private room with negative-pressure airflow.
• C. Ensure the client's room has at least six air exchanges per hour.
• D. Ensure the client wears a mask when outside their room if there is construction in the area.

Correct answer: A

Rationale: In a protective environment for a client with an allogeneic stem cell transplant, the nurse needs to wear an N95 respirator when providing direct care to the client. This precaution is essential to protect the client, whose immune system is compromised after the transplant, from exposure to potential pathogens. Placing the client in a private room with negative-pressure airflow (choice B) is more appropriate for clients with airborne infections. Ensuring the client's room has sufficient air exchanges (choice C) is important for maintaining air quality but is not the primary precaution for protecting an immunocompromised client. Making the client wear a mask when outside the room due to construction (choice D) focuses on external factors and does not directly address the risk of infection during direct care.

4. An RN is explaining to a student nurse what professionalism in nursing means. Which of the following statements, if made by the student nurse, demonstrates teaching has been successful?

• A. Commitment to others means I should be honest and accountable for my actions.
• B. I should encourage my fellow nurses to talk when they are having a bad day.
• C. I should be flexible with myself and my fellow nurses when it comes to the dress code.
• D. If I need a day off, I should promptly call in sick to give my manager plenty of time to find a replacement.

Correct answer: A

Rationale: Commitment to others involves accountability for one’s actions, lifelong learning, and commitment to colleagues.

5. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?

• A. Document the surgeon's instructions in the client's medical record.
• B. Complete an incident report.
• C. Consult the charge nurse.
• D. Notify the nursing manager.

Correct answer: D

Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.

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