Leadership, Management and Research

Why D is correct

Nursing-sensitive indicators are outcomes shown to vary directly with the amount and quality of nursing care, such as patient falls and hospital-acquired pressure injuries, and are used specifically to evaluate and improve nursing practice.

Why the other options are wrong

• A — rate of patients readmitted within 30 days: readmissions are a multidisciplinary outcome driven by many factors beyond nursing care alone.
• B — rate of surgical-site infections after appendectomy: a genuine quality measure, but one driven mainly by surgical technique and perioperative care rather than the amount of nursing care.
• C — average time to first provider contact in the ED: this reflects throughput and staffing/flow, not the amount or quality of direct nursing care.

Why B is correct

No Good Samaritan statute has been enacted in the Philippines, though bills to create one have been filed. Such statutes shield volunteer rescuers from liability in some countries, but a nurse who stops here acts without that shield.

Why the other options are wrong

• A — A statute protects any nurse who voluntarily stops to assist states the belief the question is testing, and it describes other jurisdictions rather than this one.
• C — A nurse is legally obliged to render aid to any stranger in need has real force on ethical grounds, but no general legal duty arises without a professional relationship. What pulls him toward that crash is the Code of Ethics rather than a statute.
• D — A nurse who assists becomes immune from every negligence claim overstates even a real Good Samaritan law, none of which protects a rescuer who is grossly negligent.

Why B is correct

Her assessments are measured against what a reasonably prudent nurse with similar training would have done in the same circumstances.

A nurse practicing under the Philippine Nursing Act, Republic Act 9173, answers for professional negligence when her care is challenged. Professional negligence is measured against professional practice, not against lay conduct and not against one employer's own rules. What is compared is her conduct against that standard, not the result against what the surgeon expected. Two shifts of assessments recording an intact wound while a dehiscence widened fall below that standard.

Why the other options are wrong

• A — "The care an ordinary prudent person would have given": the ordinary reasonable-person test governs lay conduct rather than the practice of a licensed profession. Holding a nurse to it measures her against the wrong yardstick and would excuse a failure only a nurse could be expected to catch.
• C — "The wound-assessment policy her hospital has approved for the unit": a facility policy is real evidence of what careful nurses there do, and is routinely offered as proof, but one institution cannot define the professional standard. A policy that sits below prevailing practice is itself substandard.
• D — "The recovery the surgeon expected from an uncomplicated CABG": liability turns on conduct measured against a standard, not on whether the outcome matched expectations. A poor result without a breach is not actionable.

Writing her beliefs down and setting them aside keeps them out of what the women tell her.

Bracketing is the phenomenologic researcher's way of holding her own view still. A researcher who expects a certain kind of distress will ask about it, hear it and write it up. The account would then be partly hers. Naming the expectation first makes it visible enough to hold back while the participant speaks.

• A — "Recording an audit trail for later reviewers": Written decisions do create an audit trail, and that record is important evidence of rigor, but the setting aside does its work during the interview.
• Correct answerB — "Keeping her expectations out of the participants' accounts": Correct. Her expectations are parked so the women's own meanings shape the findings.
• C — "Building rapport with the women before interviewing": Rapport is built with the women themselves, not alone at a desk beforehand.
• D — "Choosing which themes the analysis will report": Themes in this tradition come out of the transcripts. Deciding them in advance is the opposite of bracketing.

Why A is correct

Benchmarking is the quality-improvement technique of systematically comparing an organization's performance data against external reference points — top-performing peer units and recognized national standards — to identify gaps and set improvement targets, exactly what the manager is doing.

Why the other options are wrong

• B — trend analysis: tracks a unit's own metrics over time to spot patterns, not a comparison against external peer or national data.
• C — peer review: evaluates individual clinicians' practice or specific cases against professional standards, not systematic comparison of unit-level performance data.
• D — internal audit: checks the unit's own records and processes against its own policies, not against outside benchmarks.