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1. Which of the following scenarios would be an example of shared governance on a nursing unit?
- A. Staff nurses delegate activities to CNAs.
- B. Procedure manuals are written by a committee of nurse managers.
- C. Staff nurses and CNAs make their own schedules.
- D. A unit manager seeks advice from her supervisor.
Correct answer: C
Rationale: The correct answer is C. Shared governance in a nursing unit involves staff nurses and CNAs having autonomy and decision-making power in aspects like scheduling, which is reflected in them making their own schedules. This scenario aligns with the philosophy of shared governance where nursing practice is best determined by nurses. Choices A, B, and D do not exemplify shared governance as they involve hierarchical delegation, managerial decision-making, and seeking advice from superiors rather than autonomous decision-making by frontline staff.
2. What is the primary goal of discharge planning?
- A. Reducing readmission rates
- B. Improving patient outcomes
- C. Ensuring continuity of care
- D. Ensuring medication adherence
Correct answer: C
Rationale: The primary goal of discharge planning is to ensure continuity of care for patients transitioning from one level of care to another. While reducing readmission rates and improving patient outcomes are important aspects of discharge planning, the main focus is on coordinating care to prevent gaps and ensure a seamless transition for the patient. Ensuring medication adherence is also crucial but falls under the broader goal of continuity of care.
3. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?
- A. Teach the patient about administering regular insulin.
- B. Schedule the patient for a fasting blood glucose level.
- C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
- D. Provide teaching about an increased risk for fetal problems with gestational diabetes.
Correct answer: B
Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.
4. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?
- A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
- B. Incompetence only impacts the individual nurse.
- C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
- D. Most nurse practice acts direct how to handle incompetent nurses.
Correct answer: C
Rationale: Incompetence jeopardizes patient safety. Therefore, the formal process for handling these practices should be followed.
5. Which of the following best defines the role of a nurse practitioner (NP)?
- A. Provide direct patient care under the supervision of a physician
- B. Diagnose and treat medical conditions independently
- C. Assist with administrative tasks in a healthcare setting
- D. Specialize in a specific area of nursing practice
Correct answer: B
Rationale: The correct answer is B: 'Diagnose and treat medical conditions independently.' Nurse practitioners (NPs) are advanced practice registered nurses who are qualified to diagnose and treat medical conditions without direct supervision from a physician. Choice A is incorrect because NPs have the autonomy to provide care independently. Choice C is incorrect as NPs focus on clinical care rather than administrative tasks. Choice D is incorrect as specializing in a specific area of nursing practice refers to a different aspect of advanced nursing roles, such as becoming a clinical nurse specialist.
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