Nursing Elites

1. A technique used to eliminate negative behavior by ignoring the behavior is known as __________.

• A. Punishment
• B. Extinction
• C. Shaping
• D. Equity

Correct answer: B

Rationale: The correct answer is B, 'Extinction.' Extinction is a behavioral psychology technique where undesirable behavior is ignored, leading to its eventual decrease or elimination. This process involves withholding reinforcement that was previously maintaining the behavior. Choice A, 'Punishment,' involves applying negative consequences to reduce unwanted behavior, which is different from extinction. Choice C, 'Shaping,' is a method of gradually molding or reinforcing behaviors to reach a desired behavior, not ignoring negative behavior. Choice D, 'Equity,' refers to fairness and equal treatment, which is unrelated to eliminating negative behavior through ignoring it.

2. Which of the following would a nurse suggest are significant benefits to an organization that is considering adoption of a practice partnership model? (Select one that does not apply.)

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

Correct answer: B

Rationale: The correct answer is B. Practice partnership models are shown to be the most cost-effective of the nursing care delivery systems, contrary to being more expensive. Clients express greater satisfaction due to the collaborative and holistic approach of this model. Continuity of care is improved when the healthcare team works together cohesively. While leadership acceptance is beneficial, it is not the most significant benefit highlighted in the context of practice partnership models.

3. 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.

4. In our culturally diverse society, barriers to health care result from:

• A. Prejudice
• B. Different socioeconomic status
• C. Differences in language
• D. All of the above

Correct answer: D

Rationale: In a culturally diverse society, barriers to health care can stem from various factors. These include differences in language, various socioeconomic statuses, and prejudices. These factors can create obstacles for individuals in accessing healthcare services. Therefore, the correct answer is 'All of the above' as all the provided choices contribute to barriers in healthcare access. Choice A, 'Prejudice,' is correct as biases and discrimination can prevent individuals from receiving proper care. Choice B, 'Different socioeconomic status,' is accurate as financial disparities can limit access to healthcare services. Choice C, 'Differences in language,' is also valid as language barriers can hinder effective communication and understanding between patients and healthcare providers.

5. 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.

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