Nursing Elites

1. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?

• A. Document the surgeon's instructions in the client's medical record.
• B. Complete an incident report.
• C. Consult the charge nurse.
• D. Notify the nursing manager.

Correct answer: D

Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.

2. How are values learned?

• A. Reading books
• B. Formal degrees
• C. Continuous reinforcement
• D. Meeting diverse individuals

Correct answer: C

Rationale: Values are learned through continuous reinforcement, where behaviors or beliefs are strengthened by consequences or rewards. Reading books (choice A) may expose individuals to different perspectives and values, but the active learning and internalization of values typically occur through reinforcement. Formal degrees (choice B) may provide education and knowledge, but values are more likely to be ingrained through continuous reinforcement. Meeting diverse individuals (choice D) can also influence values, but the consistent reinforcement of desired behaviors is a more direct method for learning values.

3. Which of the following is a key principle of the patient-centered care model?

• A. Healthcare provider satisfaction
• B. Cost reduction
• C. Patient autonomy
• D. Provider convenience

Correct answer: C

Rationale: The correct answer is C: Patient autonomy. Patient-centered care focuses on respecting and responding to patient preferences and needs, making patient autonomy a key principle. Choices A, B, and D are incorrect because the patient-centered care model prioritizes the patient's well-being and involvement in decision-making over healthcare provider satisfaction, cost reduction, or provider convenience.

4. Which regulatory body mandates the provision of immunizations, especially for hepatitis B?

• A. American Nurses Association (ANA)
• B. Occupational Safety and Health Administration (OSHA)
• C. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
• D. State board of nursing

Correct answer: B

Rationale: The correct answer is B - Occupational Safety and Health Administration (OSHA). OSHA mandates that the hepatitis B vaccine series must be offered to healthcare workers who are not immune to hepatitis. This requirement aims to protect healthcare workers from occupational exposure to bloodborne pathogens, including the hepatitis B virus. The American Nurses Association (ANA) (Choice A) is a professional organization for nurses, not a regulatory body. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (Choice C) focuses on accrediting healthcare organizations for quality and safety, not mandating immunizations. The State board of nursing (Choice D) is responsible for regulating nursing practice within a specific state, not mandating immunizations.

5. One reason for conducting a comprehensive medical exam on an applicant is:

• A. It is needed to protect the organization from legal actions.
• B. It is required after a strenuous interview.
• C. It is mandated by law.
• D. It is necessary to screen for disabilities that may impact employment.

Correct answer: A

Rationale: Conducting a comprehensive medical exam on an applicant is crucial to protect the organization from legal actions. This examination helps ensure that the applicant meets the health standards required for the job, reducing the risk of potential liabilities for the organization related to health issues that may arise during employment. Choice B is incorrect because the exam is not a follow-up to a strenuous interview. Choice C is incorrect as not all comprehensive medical exams are mandated by law; they are often part of an organization's policy. Choice D is incorrect as the primary goal of the exam is to assess the applicant's health status in relation to the job requirements, not to screen for disabilities.

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