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. A client who is nonambulatory notifies the nurse that their trash can is on fire. After the nurse confirms the presence of the fire, which of the following actions should the nurse take next?

• A. Activate the emergency fire alarm.
• B. Extinguish the fire.
• C. Evacuate the client.
• D. Confine the fire.

Correct answer: D

Rationale: In this situation, the nurse's priority should be to confine the fire. By confining the fire, the nurse can prevent it from spreading further and causing more harm. Activating the emergency fire alarm (choice A) is important but should come after confining the fire. Extinguishing the fire (choice B) might not be safe for the nurse to do without proper equipment and training. Evacuating the client (choice C) can be considered once the fire is confined to ensure the client's safety.

3. A nurse is caring for a client with a diagnosis of terminal cancer. Which of the following statements by the client should indicate to the nurse that the client is ready to hear information regarding palliative care?

• A. "I am ready to learn about chemotherapy to help cure my cancer."
• B. "I just want you to give me something to get this over with soon."
• C. "I want you to tell me about measures available to keep me comfortable."
• D. "I know that many people have recovered fully from cancer, and so will I."

Correct answer: C

Rationale: Choice C is the correct answer because the client expressing a desire to know about measures available to keep comfortable indicates readiness for palliative care. Palliative care focuses on providing comfort, symptom management, and improving the quality of life for patients with serious illnesses such as terminal cancer. Choices A, B, and D are incorrect. Choice A indicates a desire for chemotherapy to cure the cancer, which does not align with palliative care goals. Choice B expresses a wish to end the situation quickly, which may not be in line with palliative care that focuses on comfort and quality of life. Choice D shows optimism about a full recovery, which may not be realistic for a client with terminal cancer who needs palliative care.

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. 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.

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