Nursing Elites

1. A registered nurse (RN) is caring for a patient who is one of Jehovah’s Witnesses and has refused a blood transfusion even though her hemoglobin is dangerously low. After providing information about all the alternatives available and risks and benefits of each, the health-care provider allows the patient to determine which course of treatment she would prefer. The RN knows this is an example of which ethical principle?

• A. Autonomy
• B. Nonmaleficence
• C. Beneficence
• D. Distributive justice

Correct answer: A

Rationale: This is an example of the ethical principle of autonomy.

2. There are several elements in recruiting strategies. Which of the following is one of those elements?

• A. Not selling
• B. How to sell
• C. When to sell
• D. What to sell

Correct answer: B

Rationale: The correct answer is B: 'How to sell.' In any recruiting strategy, key elements include where to look, how to look, when to look, and finally, how to sell. 'How to sell' refers to the tactics and techniques used to attract and persuade potential candidates. Choices A, C, and D are incorrect because 'Not selling,' 'When to sell,' and 'What to sell' are not primary elements in recruiting strategies.

3. Which of the following are significant benefits to an organization that is considering adoption of a practice partnership model? (Select all that apply.)

• A. Clients express reduced satisfaction.
• B. It is less expensive to implement than other models.
• C. Continuity of care is facilitated.
• D. Leadership is well accepted.

Correct answer: C

Rationale: The correct answer is C: Continuity of care is facilitated. One of the significant benefits of a practice partnership model is that it facilitates continuity of care, which can lead to better outcomes for clients. Choice A is incorrect as clients would not express reduced satisfaction with this model; in fact, greater client satisfaction is a benefit. Choice B is incorrect because the cost-effectiveness of the model is not specified or guaranteed. Choice D is incorrect as the acceptance of leadership is not explicitly mentioned as a significant benefit of this model.

4. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?

• A. Hemoglobin A1C level is 7.9%.
• B. Last eye exam was 18 months ago.
• C. Glomerular filtration rate is decreased.
• D. Patient has questions about the prescribed diet.

Correct answer: C

Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.

5. What is the primary objective of healthcare accreditation programs?

• A. To increase financial profitability
• B. To ensure patient safety and quality care
• C. To streamline healthcare operations
• D. To reduce hospital readmissions

Correct answer: B

Rationale: The primary objective of healthcare accreditation programs is to ensure patient safety and quality care by meeting established standards. Choice A is incorrect because while financial aspects may be indirectly impacted, the main focus is on patient care. Choice C is incorrect as the primary goal is not operational efficiency but rather quality of care. Choice D is incorrect as reducing hospital readmissions is a specific goal that may be influenced by accreditation but not the primary objective.

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