Nursing Elites

1. What is the term for working on a schedule within the unit, involving only those who are working within that unit?

• A. Flexible staffing
• B. Self-staffing
• C. Internal pools
• D. Management scheduling

Correct answer: B

Rationale: The correct answer is B, self-staffing. Self-staffing is the model where staff entirely manage staffing and scheduling themselves, without external involvement. Choices A, C, and D are incorrect. Flexible staffing refers to adjusting staffing levels based on demand. Internal pools involve a group of staff who can be drawn upon for scheduling needs. Management scheduling typically involves supervisors or managers creating and managing schedules for the unit.

2. 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.

3. A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following statements should the nurse identify as an indication that the client understands the preoperative teaching they received about pain management?

• A. ''I think I should take my pain medication more often, since it is not controlling my pain.''
• B. ''Breathing faster will help me keep my mind off of the pain.''
• C. ''It might help me to listen to music while I'm lying in bed.''
• D. ''I don't want to walk today because I have some pain.''

Correct answer: D

Rationale: The correct answer is D because the client is demonstrating an understanding of the preoperative teaching by acknowledging the pain and relating it to the need to rest. Walking may exacerbate the pain, and the client's decision not to walk shows an awareness of their body's signals. Choices A, B, and C are incorrect as they do not reflect a good understanding of pain management. Choice A suggests self-medicating without consulting healthcare providers, choice B focuses on distraction rather than addressing the pain, and choice C offers a coping mechanism but does not address the pain directly.

4. Which of the following is an example of a secondary prevention activity?

• A. Blood pressure screening
• B. Administering medications
• C. Developing a care plan
• D. Providing rehabilitation

Correct answer: A

Rationale: The correct answer is A, blood pressure screening. Secondary prevention aims to identify and treat conditions early to prevent their progression. Blood pressure screening helps in early detection of hypertension, allowing for timely intervention. Choices B, C, and D are not examples of secondary prevention activities. Administering medications (B) can be part of treatment after a condition is diagnosed, developing a care plan (C) is more related to organizing and coordinating care rather than prevention, and providing rehabilitation (D) focuses on recovery and improvement post-diagnosis rather than early detection and prevention.

5. The time period to give as notice for an appraisal is:

• A. One day.
• B. None.
• C. One week.
• D. Two days.

Correct answer: D

Rationale: The correct answer is D: 'Two days.' It is preferable to give two days' notice for a performance appraisal. Giving only one day's notice (Choice A) might not provide sufficient time for the employee to prepare adequately for the appraisal. Choice B, 'None,' is incorrect because it is essential to give advance notice for an appraisal to allow the employee time to get ready. Choice C, 'One week,' is too long of a notice period for a standard performance appraisal and could lead to unnecessary delays.

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