Little’s Law, L = λW, holds:

An M/M/c system has an arrival rate of 20 customers per hour and a mean service time of 9 minutes. What is the smallest number of servers c for which the system reaches steady state?

An Rn is working with one LPN and one UAP on a medical-surgical unit. Which action demonstrates the most appropriate prioritization and delegation? 

A single inspection station receives parts according to a Poisson process at 5 per hour. The mean inspection time is 10 minutes and its standard deviation is 6 minutes. Use the M/G/1 formula to find the average number of parts waiting, Lq. Round to 2 decimals.

The RN receives the 0700 handoff and must determine which patient requires immediate assessment. Which action is the highest priority?

Six weeks after implementation of a revised consultation policy, the nurse manager reports the following things:  (1) Average time to specialty consultation decreased from 19 hours to 7 hours (2) Three patients required emergency escalation under the revised process(3) No serious adverse events were attributed to delayed consultation during the 6-week review period (4) Staff reporting of potential safety concerns increased by 40%(5) Consultation expenditures increased by 11%(6) Senior administration questions whether the policy should be reversed because of higher costs  The nurse manager is asked to make a recommendation to the hospital’s executive leadership team.  Which recommendation by the nurse manager demonstrates the most comprehensive application of ethical nursing leadership?

A newly licensed nurse reports that a senior nurse has repeatedly made sarcastic remarks about the new nurse’s clinical abilities during shift report. The nurse manager initially encourages the nurses to work through the disagreement themselves. Two weeks later, the new nurse reports that the behavior continues and states, “I’m afraid to ask questions because I don’t want to be embarrassed again”. Which action by the nurse manager is the priority?

The charge nurse recognizes multiple ethical concerns related to Mr. Reynolds’ care. Which action should the charge nurse take first?

For each scenario, identify the primary advocacy domain represented. Situation Strategy A nurse provides information about treatment alternatives and helps a patient communicate their preferences to the provider.   A unit manager addresses an institutional practice that discourages nurses from reporting unsafe workloads. A nursing association representative meets with legislators regarding statewide nurse staffing standards. A nurse manager supports a staff member who fears retaliation after identifying repeated medication safety concerns. A bedside RN arranges an interpreter so patient can participate in healthcare decisions. A nurse leader works with administrator to redesign a system that routinely delays specialty care for uninsured patients.  

A medical-surgical unit has maintained its hospital-acquired pressure injury rate below the national benchmark for four consecutive quarters. The nurse manager proposes a new prevention initiative after identifying differences in how staff perform skin assessments. Several experienced RNs question the need for additional interventions because the unit already meets organizational standards. Which response by the nurse manager best reflects continuous quality improvement?