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? 

A patient receives the wrong concentration of an IV medication and requires transfer to the ICU. During the RCA, the team discovers that two concentrations of the medication are stored in nearly identical packaging, the unit was short-staffed, and the barcode scanner had malfunctioned repeatedly during the shift. Which actions are consistent with a just culture approach? 

A new packaging step has no historical data. An experienced supervisor can only give you the shortest, the most likely and the longest time for the step. Which distribution should you use?

Which statement by a nursing student demonstrates correct understanding of authority? 

Customers arrive at a coffee shop at an average rate of 30 per hour and spend an average of 12 minutes in the shop. What is the average number of customers in the shop, L?

A provider prescribes an IV medication to a patient with a documented history of life-threatening reaction to the same medication. The assigned RN questions the order, but the provider responds, “I’m aware of the allergy. Administer it anyway”. What should the RN do? 

When would you use queueing theory and not simulation? When is simulation needed instead? Give one example of each.

For the same tool crib (Poisson arrivals at 24 per hour, one attendant, exponential service averaging 2 minutes), what is the average time a mechanic spends at the crib, W? Answer in minutes.