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A nurse is counseling a novice nurse who gives 150% effort at all times and is becoming frustrated with a healthcare system that provides substandard care to patients. Which of the following advice would be appropriate in this situation? Select all that apply.
- A. Tell the new nurse to help other nurses perform their jobs to ensure quality patient care is being delivered.
- B. Encourage the new nurse to leave her problems at work behind, instead of rehashing them at home.
- C. After establishing a reputation for delivering quality nursing care, have her seek creative solutions for nursing problems.
- F. Have her focus on patient advocacy to improve care standards.
Correct Answer: B,C,D,F
Rationale: Advising to leave work stress behind (B), seek creative solutions after establishing credibility (C), modify unrealistic expectations (D), and focus on advocacy (F) supports the novice nurse's well-being and professional growth.
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What is the purpose of evaluation in the nursing process?
- A. to direct future nursing interventions
- B. to formulate a database of nursing diagnoses
- C. to complete an initial plan of care
- D. to transfer medical orders to the plan of care
Correct Answer: A
Rationale: Evaluation determines the effectiveness of the care plan, guiding future interventions based on patient responses.
A nurse working in a hospital setting discovers problems with the delivery of nursing care on the pediatric unit. Which of the following suggestions from the Institute of Medicines Committee on Quality of Health Care in America (Kohn, Corrigan, & Donaldson, 2000) could help redesign and improve care? Select all that apply.
- A. Base care on continuous healing relationships.
- B. Customize care based on available resources.
- C. Keep the nurse as the source of control.
- D. Share knowledge and allow for free flow of information
- E. Practice evidence-based decision making
- F. Emphasize safety as a system property.
Correct Answer: A,D,E,F
Rationale: The Institute of Medicine emphasizes continuous healing relationships (A), knowledge sharing (D), evidence-based practice (E), and safety as a system property (F) to improve care quality.
A nurse forgets to raise the railings of the bed of a patient who is confused after taking pain medications. The patient attempts to get out of bed, and suffers a minor fall. The nurse asks a colleague who witnessed the fall not to mention it to anyone because the patient only had minor bruises. What would be the appropriate action of the colleague?
- A. No other steps need to be taken, since the patient was not seriously injured.
- B. The colleague should inform the nurse that a full report of the incident needs to be made.
- C. The colleague should monitor the patient closely for any adverse effects of the fall.
- D. The colleague should report the incident in a peer review of the nurse.
Correct Answer: B
Rationale: Reporting the incident ensures patient safety and compliance with ethical and legal standards, regardless of injury severity.
Which of the following would not be part of the nurses decision about care after evaluating the patients responses to the plan of care?
- A. terminate the plan of care
Correct Answer: D
Rationale: The options are incomplete, but based on standard nursing practice, transferring medical orders (D) is not part of evaluation decisions, which focus on continuing, modifying, or terminating the plan.
Which of the following are major premises of a quality-improvement program? Select all that apply.
- A. It focuses on organizational structure.
- B. It is driven by external factors.
- C. It focuses on processes rather than individuals.
- D. It has no end points.
- E. Its outcome is focused on assuring quality.
- F. It focuses on data and statistical thinking.
Correct Answer: C,D,F
Rationale: Quality-improvement programs emphasize processes (C), continuous improvement without endpoints (D), and data-driven decision-making (F).