Nursing Elites

1. One of the most important driving forces behind health care policy changes is which of the following?

• A. New technology
• B. Outsourcing of services
• C. Emerging role of nurse practitioners
• D. Ability to pay for health care

Correct answer: D

Rationale: The correct answer is D, 'Ability to pay for health care.' One of the primary factors influencing health care policy changes is the financial aspect, as the ability to afford healthcare services affects access, quality, and equity. While new technology, outsourcing of services, and the emerging role of nurse practitioners may also impact health care policies, the fundamental driver often revolves around individuals' and societies' financial capacity to pay for healthcare.

2. During a physical assessment of adult clients, which of the following techniques should the nurse use?

• A. Use the Face, Legs, Activity, Cry, and Consolability (FLACC) pain rating scale for a client experiencing pain.
• B. Palpate the client's abdomen before auscultating bowel sounds.
• C. Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.
• D. Obtain an apical heart rate by auscultating at the third intercostal space to the left of the sternum.

Correct answer: B

Rationale: When performing a physical assessment, it is essential to palpate the client's abdomen before auscultating bowel sounds. This sequence helps prevent altering bowel sound results due to the pressure applied during palpation. Choice A is incorrect because the FLACC pain rating scale is typically used for nonverbal or pediatric clients, not adults. Choice C is incorrect because the bladder of the blood pressure cuff should surround about 80% of the client's arm circumference, not the bladder of the cuff itself. Choice D is incorrect because to obtain an apical heart rate, auscultation should be done at the fifth intercostal space at the midclavicular line, not at the third intercostal space to the left of the sternum.

3. A nurse has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?

• A. The client reports relief of nausea.
• B. The tube aspirate has a pH less than 5.
• C. Bowel sounds are present on auscultation.
• D. An x-ray shows the end of the tube above the pylorus.

Correct answer: A

Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.

4. Which of the following is an example of an outcome measure in healthcare?

• A. Patient satisfaction scores
• B. Length of hospital stay
• C. Healthcare provider performance reviews
• D. Number of diagnostic tests ordered

Correct answer: A

Rationale: Patient satisfaction scores are considered an outcome measure in healthcare because they reflect the patient's experience and perception of the care received. Patient satisfaction scores focus on the quality of care provided and the patient's overall satisfaction with their healthcare experience. Choices B, C, and D are not examples of outcome measures. The length of hospital stay is a process measure, healthcare provider performance reviews are a provider-specific evaluation, and the number of diagnostic tests ordered is more related to resource utilization rather than a direct patient outcome.

5. A nurse manager asks the staff to submit written suggestions for a change in policy. The group would then vote on the different suggestions. What type of decision-making technique did the nurse manager use?

• A. Statistical aggregation
• B. Nominal group technique
• C. Brainstorming
• D. Delphi

Correct answer: B

Rationale: The nurse manager used the nominal group technique. This technique involves group members submitting written suggestions, followed by a voting process. Statistical aggregation involves analyzing numerical data, not suggestions. Brainstorming focuses on generating creative ideas collectively, without a structured voting process. Delphi technique involves reaching a consensus through a series of questionnaires or surveys, without a direct voting process.

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