Nursing Elites

1. Achieving Magnet Hospital designation offers hospitals the following advantages: (Select one that does not apply.)

• A. Greater client satisfaction.
• B. Improved nursing recruitment.
• C. Greater client workload.
• D. Nurses who are independent decision makers.

Correct answer: C

Rationale: The correct answer is C. Achieving Magnet Hospital designation provides advantages such as greater client satisfaction, improved nursing recruitment, and nurses who are independent decision makers. However, the statement about 'Greater client workload' is not a typical advantage associated with Magnet recognition. Organizations that achieve Magnet recognition focus on improving nursing work environments, empowering nurses, and enhancing patient care quality, rather than increasing client workload. Therefore, C is the correct choice. Choices A, B, and D are incorrect because they align with the benefits of achieving Magnet Hospital designation as they lead to increased satisfaction, better recruitment, and more empowered nurses.

2. Which of the following factors may affect successful communication?

• A. Cultural background
• B. Organizational structure
• C. Method of communication
• D. All of the above

Correct answer: D

Rationale: Various factors can influence successful communication. Cultural background is crucial as different cultures may have distinct communication styles and norms. Organizational structure plays a role by determining the flow of information within an organization. The method of communication chosen can impact the clarity and effectiveness of the message being conveyed. Therefore, all the options provided - cultural background, organizational structure, and method of communication - can affect successful communication, making 'All of the above' the correct answer.

3. 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.

4. After change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

5. Healthcare systems primarily have functional structures. Which of the following would be an example of this?

• A. Open communication exists between Physical Therapy and Nursing.
• B. Medicine has authority over nursing.
• C. Laboratory services have little authority.
• D. All nursing tasks fall under nursing service.

Correct answer: D

Rationale: The correct answer is D. In functional structures, employees are grouped in departments by specialty, with similar tasks being performed by the same group. This means that in a healthcare system with a functional structure, all nursing tasks would fall under the nursing service. Choices A, B, and C are incorrect because open communication between departments, one department having authority over another, or the level of authority of a particular department do not necessarily represent a functional structure.

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