Nokea
Which action represents the key management function of strategic planning?
- A. Determining that all nurses on the unit understand the current organizational philosophy
- B. Evaluating the communication process between the pharmacy and the nursing departments
- C. Monitoring data from the quality management initiative related to the last three orientation programs
- D. Developing a 5-year plan that will incorporate the clinical nurse leader as a part of all nursing units
Correct Answer: D
Rationale: The correct answer is D because developing a 5-year plan that incorporates the clinical nurse leader aligns with strategic planning, which involves setting long-term goals and outlining strategies to achieve them. This action demonstrates forward-thinking and aligns with the organization's overall vision.
A: Ensuring nurses understand organizational philosophy is important but does not specifically relate to strategic planning.
B: Evaluating communication processes is more operational or tactical in nature, not directly tied to long-term strategic planning.
C: Monitoring data from a quality management initiative is important for quality improvement but does not directly relate to future planning and strategy development.
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Ethics applied to nursing can best be defined as:
- A. doing what is best for the client.
- B. making good decisions about care.
- C. care based on what should be done in keeping with the values of the client.
- D. rules for providing competent care that is based on scientific principles.
Correct Answer: C
Rationale: Ethics applied to nursing can best be defined as care based on what should be done in keeping with the values of the client (Choice C). This answer emphasizes the importance of respecting the client's values and preferences in decision-making, which is a fundamental aspect of ethical nursing practice. It involves considering the client's beliefs, culture, and autonomy when providing care.
Other choices are incorrect:
A: Doing what is best for the client (Choice A) is subjective and may not always align with the client's values.
B: Making good decisions about care (Choice B) is vague and does not specifically address the ethical considerations related to the client's values.
D: Rules for providing competent care based on scientific principles (Choice D) focus on clinical competence rather than the ethical dimension of nursing practice.
A patient with complicated diabetes is scheduled for a below the knee amputation at 7 AM. The surgical team adheres to the 2012 National Patient Safety Goals by implementing which protocols? (select all that apply)
- A. The surgical team asks the patient to verify his or her name, type of surgery, and limb to be removed.
- B. Ask each member of the surgical team to provide a copy of licensure and, if applicable, certification to patient and family.
- C. The surgical team uses the chart number and name/hospital number to ensure they have the correct patient.
- D. Mark the procedure site with "X" and again ask the patient to verify correct site.
Correct Answer: A
Rationale: The correct answer is A because it aligns with the 2012 National Patient Safety Goals, specifically the goal of improving the accuracy of patient identification. By asking the patient to confirm their name, type of surgery, and limb to be removed, the surgical team is ensuring that they have the correct patient and are performing the correct procedure. This protocol helps prevent errors and ensures patient safety.
Option B is incorrect because asking for licensure and certification does not directly relate to patient safety or accurate patient identification.
Option C is incorrect because relying solely on chart numbers or hospital numbers may not be sufficient to prevent errors in patient identification.
Option D is incorrect because while marking the procedure site is important, relying solely on the patient to verify the correct site may not be as effective as having the healthcare team confirm this information with the patient.
An inexperienced nurse has heard of other novice nurses who take shortcuts in providing patient care. This nurse feels that this is unacceptable and that all tasks must be performed faultlessly, which leads to her inability to complete all assigned tasks. This nurse would benefit from the seminar "Obstacles to Time Management: How to Deal with:
- A. Creativity."
- B. Perfectionism."
- C. Failure."
- D. Downtime."
Correct Answer: B
Rationale: The correct answer is B: Perfectionism. This nurse's belief that all tasks must be performed faultlessly is indicative of perfectionism, which can lead to inefficiency and inability to prioritize tasks effectively. By attending a seminar on overcoming perfectionism, the nurse can learn strategies to manage time more efficiently and prioritize tasks based on their importance. Creativity (option A) is not directly related to the nurse's struggle with completing tasks. Failure (option C) does not address the root cause of the nurse's issue. Downtime (option D) does not address the underlying perfectionism that is hindering the nurse's time management.
In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees' health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin's planned change?
- A. Unfreeze
- B. Move
- C. Refreeze
- D. Acceptance
Correct Answer: A
Rationale: The correct answer is A: Unfreeze. In this scenario, the handout is aimed at creating dissatisfaction with the current state of health insurance among employees, which aligns with the unfreezing stage of Lewin's planned change model. Unfreezing involves creating awareness of the need for change by highlighting deficiencies in the current state. The handout is triggering employees to reevaluate their current health insurance and consider alternative options. Choices B, C, and D are incorrect because they do not capture the initial stage of creating dissatisfaction and readiness for change, as seen in the unfreezing phase.
Which statement made by an RN regarding delegation indicates the need for additional teaching? (select all that apply)
- A. Unlicensed assistive personnel (UAP) can assess vital signs during the first 5 minutes for a patient who is receiving a blood transfusion because a reaction at this time is unlikely.
- B. An LPN/LVN can administer a PPD (tuberculin skin test) if there is no history of a positive PPD.
- C. When dopamine is ordered continuously, the LPN/LVN can administer dopamine at a low dose for the purpose of increasing renal perfusion.
- D. UAPs can transfer a patient who is being discharged home from the wheelchair to the bed if they have received training and demonstrated competency.
Correct Answer: A
Rationale: The correct answer is A. Delegating the assessment of vital signs during the first 5 minutes of a blood transfusion to UAPs is not appropriate. This is because a reaction can occur within the first few minutes of a blood transfusion, making it crucial for a registered nurse to assess the patient during this critical period. UAPs do not have the education or training to recognize and manage potential adverse reactions promptly.
Choice B is incorrect because an LPN/LVN can indeed administer a PPD if there is no history of a positive result. Choice C is incorrect because LPN/LVNs should not administer medications that have a high potential for adverse effects, such as dopamine. Choice D is incorrect as transferring a patient who is being discharged home requires skilled nursing assessment and intervention, not just training in transferring techniques.