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The nurse manager wants to use evidence-based recommendations to prevent ventilator-associated pneumonia. After developing a spirit of inquiry and identifying a problem, what is the next step to effectively gather evidence for guiding practice (i.e., evidence-based inquiry)?
- A. Integrate available evidence with unit expertise.
- B. Develop the clinical question.
- C. Appraise the evidence.
- D. Identify the databases to be used.
Correct Answer: B
Rationale: The correct answer is B: Develop the clinical question. This step is crucial in evidence-based practice as it helps to focus the search for evidence. By clearly defining the clinical question, the nurse manager can determine what information is needed to address the problem of preventing ventilator-associated pneumonia. Integrating available evidence with unit expertise (choice A) comes after developing the question. Appraising the evidence (choice C) and identifying databases (choice D) are important steps, but they should come later in the evidence-based inquiry process after the question has been formulated.
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During an annual performance evaluation, a manager provides truthful feedback about the nurse's performance. What ethical principle does this represent?
- A. autonomy
- B. nonmaleficence
- C. justice
- D. fidelity
Correct Answer: D
Rationale: The correct answer is D: fidelity. Fidelity refers to the principle of being faithful or loyal to commitments and obligations. In this scenario, the manager providing truthful feedback during the performance evaluation demonstrates fidelity by upholding their professional duty to provide honest and accurate information to support the nurse's growth and development. Autonomy (A) relates to respecting individuals' rights to make their own decisions. Nonmaleficence (B) pertains to avoiding harm. Justice (C) involves fairness and equality in decision-making. In this context, fidelity best aligns with the manager's responsibility to maintain trust and integrity in the feedback process.
A charge nurse allows a nurse an additional twenty minutes for his lunch break to take care of a personal matter. The charge nurse agrees to watch his patients for the additional twenty minutes, only if he agrees to help with the end-of-shift drug count. The charge nurse is demonstrating which of the following types of conflict management?
- A. Avoiding
- B. Compromising
- C. Cooperating
- D. Competing
Correct Answer: B
Rationale: The correct answer is B: Compromising. Compromising involves finding a middle ground where both parties give up something to reach a mutually acceptable solution. In this scenario, the charge nurse and nurse both make concessions - the charge nurse agrees to watch the patients for an additional twenty minutes, and the nurse agrees to help with the end-of-shift drug count. This approach allows both parties to achieve their goals partially, demonstrating a compromise. Avoiding (A) would be ignoring the issue, cooperating (C) would involve working together without concessions, and competing (D) would be a win-lose situation.
A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?
- A. Review the events leading up to each medication administration error.
- B. Require staff nurses to demonstrate competency by passing a medication administration examination.
- C. Develop a quality improvement program for nurses involved in medication administration errors.
- D. Provide an inservice on medication administration to all the nurses.
Correct Answer: A
Rationale: The correct answer is A: Review the events leading up to each medication administration error. This is the first strategy the committee should initiate because it helps identify root causes of errors. By conducting a thorough review of the events leading up to each error, the committee can identify systemic issues, communication breakdowns, and other factors contributing to errors. This information is crucial for developing targeted interventions to prevent future errors.
Choice B is incorrect because competency testing alone may not address underlying system issues leading to errors. Choice C is incorrect because focusing solely on nurses involved in errors may overlook broader system issues. Choice D, providing an inservice, is also not as effective as reviewing events leading to errors, as it may not address specific causes of errors.
Mary is a newly-hired, new graduate nurse. Mary adapts her practice to imitate her co-workers on the unit. She is demonstrating:
- A. cultural awareness.
- B. cultural sensitivity.
- C. acculturation.
- D. cultural marginality.
Correct Answer: C
Rationale: Mary is demonstrating acculturation by adapting her practice to imitate her co-workers. Acculturation involves adopting the cultural norms and behaviors of a dominant group. In this scenario, Mary is assimilating into the culture of her workplace. Cultural awareness (A) is about understanding and respecting different cultures. Cultural sensitivity (B) is being aware of and respectful towards different cultures. Cultural marginality (D) refers to feeling disconnected from one's own culture and the dominant culture. In this case, Mary is actively assimilating, not feeling disconnected. Therefore, the correct answer is C.
A family is keeping vigil at a critically ill patient's bedside. The nurse speaks with the family members and asks if they would benefit from a chaplain visit or resources to aid with grief and coping. What role is the nurse assuming through this action?
- A. Follower
- B. Manager
- C. Laissez-faire
- D. Leader
Correct Answer: D
Rationale: The correct answer is D: Leader. By offering resources and support to the family during a difficult time, the nurse is taking on a leadership role. The nurse is demonstrating initiative, empathy, and guidance in providing options for additional assistance. This action shows the nurse's ability to take charge, make decisions, and support the family in coping with the situation.
A: Follower - Incorrect. The nurse is not following anyone's lead but rather taking charge and offering support.
B: Manager - Incorrect. While the nurse is managing care, the specific action of offering resources and support goes beyond typical managerial duties.
C: Laissez-faire - Incorrect. Laissez-faire implies a hands-off approach, which is not the case here as the nurse is actively engaging with the family.
E, F, G: No options provided.