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What is the primary responsibility of a clinical nurse leader (CNL)?
- A. Supervise nursing staff
- B. Coordinate patient care
- C. Develop nursing policies
- D. Implement evidence-based practice
Correct Answer: B
Rationale: The primary responsibility of a clinical nurse leader (CNL) is to coordinate patient care. This involves overseeing the care provided to patients, ensuring proper communication between healthcare team members, and promoting efficient and effective care delivery. CNLs focus on improving patient outcomes and quality of care by coordinating various aspects of patient care. Supervising nursing staff (A) is typically the responsibility of nurse managers or charge nurses. Developing nursing policies (C) is usually the role of nurse educators or nurse administrators. Implementing evidence-based practice (D) is important for all nurses but is not the primary responsibility of a CNL, whose main focus is on coordinating patient care.
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Which of the following would a nurse suggest are significant benefits to an organization that is considering adoption of a practice partnership model? (Select one that does not apply.)
- A. Clients express greater satisfaction.
- B. It is more expensive to implement than other models.
- C. Continuity of care is facilitated.
- D. Leadership is well accepted.
Correct Answer: B
Rationale: The correct answer is B because suggesting that the practice partnership model is more expensive to implement than other models would not be a significant benefit to an organization. A: Clients' greater satisfaction would be a benefit as it could lead to improved outcomes. C: Facilitated continuity of care would also be a benefit by improving coordination and patient experience. D: Leadership being well accepted is also a benefit as it can enhance organizational effectiveness.
When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?
- A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
- B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
- C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
- D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.
Correct Answer: C
Rationale: The correct answer is C: Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
Rationale:
1. Administering insulin falls under the scope of practice for an LPN/LVN.
2. Administering lispro insulin before surgery helps maintain the patient's blood glucose within a safe range during the procedure.
3. LPN/LVNs are trained to administer medications safely and accurately.
Summary:
A: Communication with the circulating nurse requires critical thinking and interpretation, which may be beyond the scope of an LPN/LVN.
B: Discussing the reason for insulin therapy involves patient education and interpretation, which are typically responsibilities of a registered nurse.
D: Planning strategies to prevent hypoglycemia or hyperglycemia requires higher-level critical thinking and assessment skills, usually performed by a registered nurse.
Selecting a person/unit to negotiate on the group's behalf is known as:
- A. Labor negotiations.
- B. Bargaining.
- C. Establishing a union.
- D. Representation election.
Correct Answer: D
Rationale: The correct answer is D: Representation election. This process involves selecting a person or unit to negotiate on behalf of a group, typically in labor unions. It is a democratic way for employees to choose their representatives. Labor negotiations (A) are the actual discussions between parties, bargaining (B) refers to the process of reaching an agreement, and establishing a union (C) is the formation of a collective bargaining unit, all of which are steps that come after selecting the representative through a representation election.
Which of the following best describes the concept of just culture in a healthcare organization?
- A. A culture of blaming individuals for mistakes
- B. A culture of encouraging reporting and learning from errors
- C. A culture of punishing individuals for errors
- D. A culture of ignoring errors
Correct Answer: B
Rationale: The correct answer is B because a just culture in healthcare encourages reporting and learning from errors to improve patient safety and quality of care. This fosters a transparent environment where individuals feel safe to report errors without fear of punishment. By analyzing mistakes, healthcare organizations can implement preventive measures and enhance systems to prevent future errors. Choice A is incorrect as just culture avoids blaming individuals; Choice C is incorrect as it does not promote punishment but focuses on learning; and Choice D is incorrect as just culture acknowledges and addresses errors for continuous improvement.
A client experiences difficulty breathing after the change of shift. The nurse on duty discovers that the IVFs were infusing at a rate 10 times the calculated normal. After notifying the physician and correcting the rate, what should be the next step in the client's care?
- A. Notify family
- B. Discipline the previous nurse
- C. Complete an incident report
- D. Obtain legal consultation
Correct Answer: C
Rationale: The correct answer is C: Complete an incident report. This is the next step in the client's care because documenting the incident is crucial for quality improvement and patient safety. It helps identify the root cause, prevent future errors, and ensure accountability. Notifying the family (A) may be necessary but not the immediate next step. Disciplining the previous nurse (B) is not appropriate without a thorough investigation. Obtaining legal consultation (D) may be needed later but is not the immediate priority.