Nursing Elites

1. 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.

2. You believe that you are working harder than other nurses and that you take care of patients that are more complex. You are angry that other staff nurses have less complex and lower acuity patients, but you __________ .

• A. Avoid discussing the situation because you do not want to be perceived as a complainer.
• B. Know that you need to discuss the inequity with the nurse manager because you are resenting the work and becoming more dissatisfied in your job
• C. A & B
• D. None of the above

Correct answer: C

Rationale: Professionals communicate their views in a respectful and direct manner. In discussing the situation with the manager, professionals may gain insights about their reactions to stress and how they can cope with the intense demands of the healthcare environment. Choice A is incorrect because avoiding discussing the situation does not address the underlying issue and may lead to increased frustration. Choice B is correct as it emphasizes the importance of addressing the inequity with the nurse manager to find a constructive solution. Choice D is incorrect as it does not provide any guidance on how to handle the situation effectively.

3. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

4. A 34-year-old has a new diagnosis of type 2 diabetes. The nurse will discuss the need to schedule a dilated eye exam

• A. every 2 years
• B. as soon as possible
• C. when the patient is 39 years old
• D. within the first year after diagnosis

Correct answer: B

Rationale: The correct answer is 'B' - as soon as possible. Patients with type 2 diabetes should have a dilated eye exam shortly after diagnosis to check for any signs of diabetic retinopathy, a common complication of diabetes. Waiting for 2 years (choice A) may lead to missing early signs of eye damage. Choice C is incorrect as there is no specific age requirement mentioned for the eye exam. Choice D is also incorrect because early detection and intervention are crucial in diabetic eye disease.

5. In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?

• A. First
• B. Second
• C. Third
• D. Fourth

Correct answer: A

Rationale: The correct answer is A: First. In the grievance process, the initial step involves the nurse talking to the nurse manager to address the issue informally. Subsequently, step two entails filing a written appeal to the director of nursing or designee. Step three involves a formal meeting with the employee, agent, grievance chairperson, nursing administrator, and director of human resources. The final step, step four, is arbitration, which is initiated when no mutually acceptable solutions can be reached by the involved parties. Therefore, the nurse talking to the nurse manager about the disagreement is the first step in the grievance process.

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