Nursing Elites

1. All of the following are characteristics of the Patient Centered Medical Home (PCMH) except:

• A. Comprehensive in scope of care
• B. Guarantees safety at home
• C. Patient needs come first
• D. Providers work together

Correct answer: B

Rationale: The Patient Centered Medical Home (PCMH) model is designed to provide comprehensive care, prioritize patient needs, and ensure that healthcare providers work together to coordinate care effectively. However, guaranteeing safety at home is not a specific characteristic of the PCMH model. Home safety is an important aspect of patient care but is not explicitly part of the PCMH model's core principles.

2. Which of the following is an example of tertiary prevention?

• A. Vaccination
• B. Screening for cancer
• C. Physical therapy
• D. Health education

Correct answer: C

Rationale: Tertiary prevention aims to manage and improve the quality of life of individuals already diagnosed with a disease. Physical therapy, which focuses on rehabilitation and restoring function after an injury or illness, is a prime example of tertiary prevention. It helps individuals regain mobility and independence, thereby reducing the impact of the disease and preventing further complications.

3. If bleeding continues after delivery of the placenta using management, the FIRST thing you should do is call for help and:

• A. Massage the uterus
• B. Insert a urinary catheter
• C. Start an IV
• D. Check the placenta to ensure completeness

Correct answer: A

Rationale: In postpartum hemorrhage, massaging the uterus is the initial step to promote uterine contractions, which can help control bleeding by compressing the blood vessels. This action can help prevent further blood loss and stabilize the patient's condition. Calling for help is essential to ensure timely assistance, but taking immediate action by massaging the uterus is crucial in managing postpartum bleeding.

4. What factor most influences health disparities?

• A. Genetic factors
• B. Lifestyle choices
• C. Access to health care services
• D. Cultural beliefs

Correct answer: C

Rationale: Access to health care services plays a significant role in influencing health disparities as it determines individuals' ability to access necessary medical care and services. Disparities in access to healthcare can lead to differences in health outcomes and contribute to overall health disparities within populations.

5. Which of the following is the best intervention for a client with less than 6 months to live who is seeking comfort care?

• A. Set up a meeting with the hospice team
• B. Arrange a meeting with the client’s family
• C. Discuss advance directives (DNR & living will) with the patient
• D. Ask the provider to decrease the patient’s heart medications

Correct answer: A

Rationale: Setting up a meeting with the hospice team is the most appropriate intervention for a client with less than 6 months to live who is seeking comfort care. Hospice care focuses on providing comfort and support for individuals with terminal illnesses. By involving the hospice team, the client can receive specialized care aimed at improving their quality of life and managing symptoms effectively during this challenging time.

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