Hospitals surveyed nurses who terminated their employment to determine why they chose to leave. One of the most common reasons for leaving was:

Correct Answer: B

Rationale: The correct answer is B: that the nurse/patient ratio prevents safe care. This answer is correct because inadequate nurse/patient ratios have been consistently identified as a major factor contributing to nurse dissatisfaction and burnout. When nurses are responsible for too many patients, they are unable to provide safe and effective care, leading to increased stress and job dissatisfaction. Explanation of other choices: A: Decreased pay for alternative shifts: While decreased pay may be a concern for some nurses, it is not typically cited as one of the most common reasons for leaving a position. C: Most facilities are choosing an all-RN staff, which decreases opportunities for advancement: While this may be a concern for some nurses, it is not as universally impactful as unsafe nurse/patient ratios. D: Agency and foreign nurses are favored by administration over full-time nursing staff: While favoritism may be an issue in some cases, it is not typically cited as one of the most common reasons for nurses leaving their employment.

Correct Answer: B

Rationale: The correct answer is B: alumni that graduated from the same school and work in the area. Networking with alumni who graduated from the same school and work in the area is the best way to know the culture of the potential employer because they can provide insider insights based on their own experiences. Alumni are likely to offer honest and firsthand information about the work environment, company culture, and career growth opportunities. They can also provide valuable advice on how to navigate the hiring process and make an informed decision. Networking with executives at a competing agency (choice A) may not provide accurate information about the potential employer's culture. Nurses currently working in the agency (choice C) may not have a comprehensive view of the overall culture. Friends or people who have been patients at the agency (choice D) are unlikely to provide relevant insights into the work culture.

Correct Answer: C

Rationale: The correct answer is C: credible threat. In this scenario, a credible threat refers to a specific and tangible indication that a harmful event may occur. The information provided by the FBI about a bomb in possession of a known terrorist group targeting government buildings is a clear example of a credible threat. This term is specifically used in emergency management to indicate a situation where there is a realistic possibility of harm. A is incorrect because an all-hazards approach involves preparing for and responding to a wide range of potential disasters, not specifically a bomb threat. B is incorrect because a biologic event refers to an outbreak of a biological agent, not a bomb threat. D is incorrect because a natural disaster involves events caused by natural forces, not intentional acts by terrorist groups.

Correct Answer: C

Rationale: The correct answer is C because pay for performance initiatives incentivize nurses to improve patient outcomes by reducing errors and following best practices. This directly links economic incentives to nursing practice. Choice A is incorrect because the DRG system primarily affects hospital reimbursement, not nursing shortages. Choice B is incorrect as it focuses on the type of care, not the economic impact on nursing practice. Choice D is incorrect as economic factors like funding, resources, and reimbursement significantly influence nursing practice.

Correct Answer: A

Rationale: The correct answer is A: time-out. A time-out is a crucial pre-operative safety practice where the surgical team pauses to verify the patient's identity, procedure, and surgical site to prevent errors. This step ensures everyone is on the same page and reduces the risk of wrong-site surgeries. Explanation: 1. Identify patient and operative site: By verifying the patient's identity and the correct surgical site, the team prevents potential mistakes. 2. Address questions or concerns: Encouraging team members to voice any uncertainties or issues promotes open communication and collaboration. 3. Safety measure: The time-out is a key component of the World Health Organization's Surgical Safety Checklist to enhance patient safety. Summary: B: A critical pathway is a predetermined sequence of steps in patient care, not specific to surgical safety. C: Special cause variation refers to statistical process control, unrelated to surgical safety. D: Lean methodology focuses on efficiency and waste reduction in processes, not directly related to pre-operative safety checks like a time

Correct Answer: A

Rationale: The correct answer is A because it directly addresses the shortage of nursing faculty by highlighting the issue of burnout and job dissatisfaction, which leads to faculty turnover and limits enrollment. This explanation aligns with the initial statement that qualified applicants are being turned away due to the shortage of faculty. Choices B, C, and D are incorrect because they do not directly address the main issue of faculty shortage. B talks about the stability of faculty numbers in Associate Degree programs, which is irrelevant to the shortage. C discusses the decrease in the mean age of nursing faculty and the departure of older mentors, but this does not explain the shortage of faculty. D mentions increasing job competition from clinical sites, which is not the primary reason for the shortage of nursing faculty.

Correct Answer: D

Rationale: The correct answer is D: fear of completion. This is because the student nurse is prolonging the conclusion of the project despite constantly adding new information and filtering it out slowly to others. This behavior indicates a reluctance to finish the project, likely due to a fear of moving on to the next stage or fear of evaluation. The student nurse is enjoying the attention and positive feedback, leading to a delay in completing the task. A: The need for perfection is not the primary obstacle in this scenario as the student nurse is not necessarily striving for perfection but rather avoiding completion. B: Fear of losing creativity is not the main issue here as the student nurse is still adding new information, indicating creativity is not the concern. C: Unclear goals do not seem to be the obstacle as the student nurse is actively engaged in the project and receiving positive feedback.

Correct Answer: C

Rationale: The correct answer is C because delegating the task of completing a plan of care to a float LPN/LVN for a stable patient is inappropriate. LPNs/LVNs have a different scope of practice compared to RNs and should not be assigned tasks related to developing care plans. This task requires critical thinking skills and assessment that are within the RN's scope of practice. A: A is incorrect because delegating the task of greeting and showing ambulatory surgery patients to their rooms is appropriate for a nursing assistant. B: B is incorrect because delegating the task of collecting a sputum specimen, once trained, is appropriate for a nursing assistant under the supervision of an RN. D: D is incorrect because delegating the task of performing a dressing change to a competent LPN/LVN is appropriate, as long as it falls within their scope of practice.

Correct Answer: A

Rationale: The correct answer is A: the patient census. This is crucial for determining the appropriate number of staff needed to provide safe and effective care based on the current number of patients. The patient census directly impacts workload and patient acuity levels. Choices B, C, and D are incorrect because although they may be important factors to consider when staffing a medical-surgical unit, they are not as directly related to determining the immediate staffing needs based on the current patient load. The physical layout of the unit, complexity of care required, and educational level of staff are important for overall unit operations and quality of care but do not have the same immediate impact on staffing decisions as the patient census.