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. Politics is a means for influencing events and the decisions of others. The nurse manager who consistently reminds the staff that 'there is no I in team' and periodically brings treats for the staff is using:

• A. Image enhancement
• B. Political skills
• C. Reward power
• D. Expert power

Correct answer: B

Rationale: The correct answer is B: Political skills. Politics involve interpersonal endeavors, collective activities, analysis, planning, and managing image. In this scenario, the nurse manager is skillfully building team morale and influencing staff dynamics by emphasizing teamwork ('there is no I in team') and boosting morale through occasional treats. This demonstrates the use of political skills to influence and manage relationships within the team. Choices A, C, and D are incorrect because the manager's actions are not solely focused on image enhancement, reward power, or expert power. Instead, they are aimed at fostering teamwork and boosting staff morale.

3. What is the primary goal of discharge planning?

• A. Reducing readmission rates
• B. Improving patient outcomes
• C. Ensuring continuity of care
• D. Ensuring medication adherence

Correct answer: C

Rationale: The primary goal of discharge planning is to ensure continuity of care for patients transitioning from one level of care to another. While reducing readmission rates and improving patient outcomes are important aspects of discharge planning, the main focus is on coordinating care to prevent gaps and ensure a seamless transition for the patient. Ensuring medication adherence is also crucial but falls under the broader goal of continuity of care.

4. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

5. Professionalism has historically been difficult to define. Early definitions of professionalism included which of the following characteristics?

• A. Expertise
• B. Empathy
• C. Ethical and moral values
• D. Honesty

Correct answer: A

Rationale: The correct answer is A: 'Expertise.' Historically, professionalism was defined by one's knowledge and expertise in a particular field. Choices B, C, and D are incorrect because early definitions of professionalism did not focus on qualities like empathy, ethical and moral values, or honesty, but rather on the individual's level of skill and competence in their area of work.

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