Nokea
A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?
- A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
- B. Incompetence only impacts the individual nurse.
- C. The director should follow her institution’s formal process for reporting and handling practices that jeopardize patient safety.
- D. Most nurse practice acts direct how to handle incompetent nurses.
Correct Answer: C
Rationale: The correct answer is C because the director should follow the institution's formal process for reporting and handling practices that jeopardize patient safety. This is crucial to maintain high standards of patient care and ensure accountability. Choice A is incorrect as tolerating incompetence can lead to serious consequences for patient safety. Choice B is incorrect as incompetence can impact patient outcomes and overall quality of care. Choice D is incorrect as nurse practice acts may provide guidelines but the institution's specific process should be followed to address incompetence effectively.
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Which of the following is an example of a primary prevention strategy in public health?
- A. Screening for diabetes
- B. Vaccination programs
- C. Emergency response planning
- D. Chronic disease management
Correct Answer: B
Rationale: The correct answer is B: Vaccination programs. Primary prevention aims to prevent the onset of disease before it occurs. Vaccination programs are a classic example as they protect individuals from contracting infectious diseases, thus preventing the occurrence of the disease in the first place. Screening for diabetes (A) is a form of secondary prevention, aiming to detect the condition early to prevent complications. Emergency response planning (C) focuses on preparedness for disasters rather than preventing diseases. Chronic disease management (D) involves managing existing conditions rather than preventing their occurrence.
Which of the following is a characteristic of a well-written goal?
- A. Goals should be vague
- B. Goals should be unrealistic
- C. Goals need to be measurable, realistic, and achievable
- D. Goals should be easy to achieve
Correct Answer: C
Rationale: The correct answer is C because well-written goals need to be specific, measurable, achievable, relevant, and time-bound (SMART). Measurable goals allow for tracking progress, realistic goals are attainable, and achievable goals are within reach. Vague goals (A) lack clarity, unrealistic goals (B) may lead to frustration, and goals that are too easy to achieve (D) do not challenge individuals to grow and improve. Therefore, option C is the best choice for a well-written goal.
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: The correct answer is D: Notify the nursing manager. The nurse should escalate the situation to the nursing manager because the surgeon's instructions may not be appropriate for a client in hemorrhagic shock. The nurse needs to advocate for the client's safety and ensure prompt and appropriate intervention. Consulting the charge nurse may not be sufficient, and documenting the instructions or completing an incident report does not address the immediate need for proper medical intervention.
A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?
- A. Satisficing
- B. Routine
- C. Adaptive
- D. Rationalizing
Correct Answer: A
Rationale: The correct answer is A: Satisficing. Satisficing is a decision-making strategy where the decision-maker selects the first option that meets the minimum criteria or satisfies the immediate need. In this scenario, the nurse manager is making a decision to manage the unit with the three remaining nurses to meet the minimal staffing standards due to the unexpected absence of two nurses. This decision is based on satisfying the immediate need of maintaining minimal staffing levels despite not having the full staff complement available.
Summary:
B: Routine decision-making involves following established procedures and protocols, which is not the case in this scenario.
C: Adaptive decision-making involves adapting to changing circumstances, which is not the primary focus here.
D: Rationalizing decision-making involves thoroughly evaluating options and selecting the best one, which is not happening in this situation where the focus is on meeting minimum staffing standards quickly.
During a staffing crisis, managers may need to use nurse extenders. These individuals are better known as:
- A. Float RNs.
- B. Unlicensed assistive personnel.
- C. LPNs.
- D. Agency nurses.
Correct Answer: B
Rationale: The correct answer is B: Unlicensed assistive personnel. Nurse extenders are typically nursing assistants or other unlicensed staff who provide basic patient care under the supervision of registered nurses. They help alleviate the workload during staffing shortages but do not have the same level of education and training as licensed nurses. Float RNs (A) are registered nurses who work in various units as needed. LPNs (C) are licensed practical nurses who have more training than nursing assistants. Agency nurses (D) are temporary nurses hired from external agencies. Unlicensed assistive personnel best fit the description of nurse extenders due to their role in providing direct patient care under supervision.