Nursing Elites

1. Selecting a person/unit to negotiate on the group's behalf is known as:

• A. Labor negotiations.
• B. Bargaining.
• C. Establishing a union.
• D. Representation election.

Correct answer: D

Rationale: The correct answer is D, representation election. Representation election is the process where individuals within a group vote to select a person or unit to represent and negotiate on their behalf. Options A and B are incorrect because they refer to the broader concepts of labor negotiations and bargaining, not specifically the process of selecting a representative. Option C, establishing a union, is also incorrect as it refers to the formation of a labor union rather than the act of choosing a representative for bargaining.

2. Integrated health care systems function in a variety of models. Which of the following is a common characteristic of all systems?

• A. Deliver selective care only
• B. Deliver a whole continuum of care
• C. Treat patients only in the hospital
• D. Provide care only in the primary care setting

Correct answer: B

Rationale: Integrated health care systems are designed to provide a whole continuum of care, which includes preventive, primary, specialty, hospital, and long-term care services. This integration ensures that patients receive comprehensive and coordinated care across different healthcare settings. Choice A is incorrect because integrated systems aim to provide a wide range of services, not selective care only. Choice C is incorrect as integrated systems extend care beyond hospital settings. Choice D is incorrect as these systems offer care across various settings, not limited to primary care only.

3. Which statement by the patient indicates a need for additional instruction in administering insulin?

• A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
• B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
• C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
• D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'

Correct answer: A

Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.

4. The changes brought forth by the state boards of nursing are an example of which type of change agent?

• A. Resistance
• B. Empirical–rational
• C. Normative–reeducative
• D. Power–coercive

Correct answer: D

Rationale: The changes implemented by state boards of nursing typically fall under the category of Power–coercive change agents. State boards of nursing have the authority to enforce changes through regulations and policies, making use of their legitimate power. Resistance (choice A) is not the correct answer as it refers to opposition to change rather than the entity driving change. Empirical–rational (choice B) focuses on convincing individuals through empirical evidence and rational arguments, which is not reflective of the state boards' authority. Normative–reeducative (choice C) involves persuading individuals to change based on shared values and beliefs, which is not the primary approach of state boards of nursing.

5. What is the primary goal of evidence-based practice (EBP)?

• A. Reduce healthcare costs
• B. Improve patient outcomes
• C. Enhance clinical decision making
• D. Ensure patient safety

Correct answer: C

Rationale: The primary goal of evidence-based practice (EBP) is to enhance clinical decision making by integrating the best available evidence with clinical expertise and patient values. While improving patient outcomes is a significant result of EBP, the ultimate aim is to ensure that healthcare decisions are based on the most current, relevant, and reliable evidence. While reducing healthcare costs and ensuring patient safety are important in healthcare, they are not the primary goals of evidence-based practice.

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