Nursing Elites

1. A nurse is caring for a client who has a nasogastric (NG) tube and is receiving intermittent feedings through an open system. Which of the following actions should the nurse take first?

• A. Make sure the enteral formula is at room temperature.
• B. Wipe the top of the formula can with alcohol.
• C. Rinse the feeding bag with water between feedings.
• D. Tell the client to keep the head of the bed elevated at least 30°

Correct answer: B

Rationale:

2. A manager is working on the personnel budget for the year. The manager anticipates needing to replace 832 benefit hours. How many FTEs (Full-Time Equivalents) will be needed for replacement?

• A. 0.40 FTEs
• B. 17.0 FTEs
• C. 0.05 FTEs
• D. 1.0 FTEs

Correct answer: A

Rationale: To calculate the number of Full-Time Equivalents (FTEs) needed for replacement, divide the number of benefit hours (832) by the standard number of hours in a full-time work year (2,080). Therefore, 832 benefit hours ÷ 2,080 = 0.4 FTEs, which is equivalent to 0.40 FTEs. Choice B (17.0 FTEs) is incorrect as it is a significantly high number that does not align with the calculation. Choice C (0.05 FTEs) is incorrect because it is too low for the given number of benefit hours. Choice D (1.0 FTEs) is incorrect as it represents a full-time position, which is not the correct calculation for replacing 832 benefit hours.

3. When trying to facilitate change in the staff, it is necessary to build trust and recognize the need for change. This type of action is known as which of the following, according to Lewin's Force-Field Model?

• A. Moving the system to a new level
• B. Unfreezing the system
• C. Refreezing the system
• D. Institutionalization

Correct answer: B

Rationale: The correct answer is 'Unfreezing the system.' In Lewin's Force-Field Model, unfreezing is the stage where the existing equilibrium is disrupted to motivate participants and prepare them for change. Building trust and recognizing the need for change are essential components of this stage. Choice A, 'Moving the system to a new level,' does not specifically address the initial stage of disruption. Choice C, 'Refreezing the system,' comes after change has been implemented, not before. Choice D, 'Institutionalization,' refers to the stage where the change becomes the new norm, which is different from unfreezing.

4. Which of the following best describes the concept of cultural humility in nursing?

• A. A fixed set of cultural competencies
• B. Recognizing and addressing power imbalances
• C. Adapting care to fit different cultural contexts
• D. Learning from patients and adapting to their needs

Correct answer: D

Rationale: Cultural humility in nursing is about approaching patient care with an open mind, being willing to learn from patients, and adapting to their individual needs. Choice A is incorrect as cultural humility is not about a fixed set of competencies, but rather an ongoing process of self-reflection and learning. Choice B, recognizing and addressing power imbalances, is related to cultural competence but not the core concept of cultural humility. Choice C, adapting care to fit different cultural contexts, is more aligned with cultural competence rather than cultural humility.

5. What is the primary purpose of a patient-centered medical home (PCMH)?

• A. To coordinate all aspects of patient care
• B. To reduce healthcare costs
• C. To implement the latest clinical guidelines
• D. To provide financial incentives for providers

Correct answer: A

Rationale: The correct answer is A: 'To coordinate all aspects of patient care.' A patient-centered medical home (PCMH) aims to provide comprehensive and continuous care by coordinating various aspects of a patient's healthcare needs. While reducing healthcare costs and implementing clinical guidelines are important goals in healthcare, the primary focus of a PCMH is on enhancing patient care coordination to improve outcomes and patient satisfaction. Providing financial incentives for providers is not the primary purpose of a PCMH, although it can be a component of some models to encourage quality care delivery.

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