Nursing Elites

1. Which agency reviews whether an organization meets its own criteria for staffing?

• A. American Nurses Association (ANA)
• B. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
• C. Patient Classification Systems (PCSs)
• D. Nursing Care Hours (NCHs)

Correct answer: B

Rationale: The correct answer is the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This agency specifies that the right number of competent staff should be provided to meet client's needs. Choices A, C, and D are incorrect as they do not focus on the review of staffing criteria within an organization. The American Nurses Association (ANA) is an organization that supports nurses, Patient Classification Systems (PCSs) are tools used for patient classification, and Nursing Care Hours (NCHs) are related to the number of care hours provided.

2. For a 55-year-old female patient with type 2 diabetes and a nursing diagnosis of imbalanced nutrition: more than body requirements, which goal is most important?

• A. The patient will reach a glycosylated hemoglobin level of less than 7%.
• B. The patient will follow a diet and exercise plan that results in weight loss.
• C. The patient will choose a diet that distributes calories throughout the day.
• D. The patient will state the reasons for eliminating simple sugars in the diet.

Correct answer: A

Rationale: The most important goal for a 55-year-old female patient with type 2 diabetes and imbalanced nutrition due to more than body requirements is to reach a glycosylated hemoglobin level of less than 7%. This goal directly addresses the management of diabetes and is crucial in preventing complications associated with high blood sugar levels. Choice B focuses on weight loss, which may be beneficial but is not as critical as controlling blood sugar levels. Choice C, distributing calories throughout the day, is important for glycemic control but not as immediate as reaching a target HbA1c level. Choice D, stating the reasons for eliminating simple sugars, is a good educational goal but not as urgent as achieving glycemic control.

3. Which of the following is a common characteristic of a high reliability organization (HRO)?

• A. Flexibility
• B. Reluctance to simplify
• C. Preoccupation with failure
• D. Deference to expertise

Correct answer: C

Rationale: A common characteristic of a high reliability organization (HRO) is a preoccupation with failure. HROs focus on identifying and addressing potential failure points to prevent errors and maintain high levels of safety and reliability. This mindset helps them anticipate and mitigate risks proactively, leading to better outcomes and performance. Choices A, B, and D are incorrect. While flexibility, reluctance to simplify, and deference to expertise may be important in various contexts, they are not the primary defining characteristics of a high reliability organization. The core focus of HROs is on continuously monitoring for potential failures and working to prevent them.

4. Upon noticing a visitor who is loud and active and carrying a gun on the unit where you are in charge, what should you do immediately?

• A. Ask the visitor to leave.
• B. Talk quietly to calm the visitor.
• C. Ask the visitor for the gun.
• D. Notify security with the details of the situation.

Correct answer: D

Rationale: In a situation where a visitor arrives on the unit with a gun, it is essential to prioritize the safety of patients and staff. Immediately notifying security with all the relevant details is the correct course of action. Asking the visitor to leave or engaging them could escalate the situation and put everyone at risk. Similarly, requesting the gun from the visitor directly is not advisable as it could lead to a dangerous confrontation. By alerting security promptly, you enable trained professionals to handle the situation safely and effectively, minimizing risks and ensuring the safety of all individuals involved.

5. The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes. Which question is most appropriate for the nurse to ask?

• A. "Are you anorexic?"
• B. "Is your urine dark colored?"
• C. "Have you lost weight lately?"
• D. "Do you crave sugary drinks?"

Correct answer: C

Rationale: Weight loss is a common symptom in the onset of type 1 diabetes due to the body's inability to use glucose for energy. The lack of insulin leads the body to break down fat and muscle for fuel, causing unintentional weight loss. This is a more relevant question compared to the others, as it directly relates to the metabolic changes associated with type 1 diabetes.

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