Nursing Elites

1. What procedure is performed prior to a blood transfusion to detect incompatibilities?

• A. Grouping and crossmatching
• B. Complete blood count
• C. D-dimer test
• D. Blood clotting test

Correct answer: A

Rationale: Grouping and crossmatching is the procedure performed prior to a blood transfusion to determine the blood type and identify any potential incompatibilities between the donor and recipient. This process involves testing the recipient's blood for ABO and Rh antigens and crossmatching it with the donor's blood to ensure compatibility and prevent adverse reactions during the transfusion. Complete blood count, D-dimer test, and blood clotting test are other laboratory tests that serve different purposes and are not specifically done to detect incompatibilities prior to blood transfusion.

2. A community health nurse is overwhelmed with all that needs to be done in one day. Which task could most easily be postponed?

• A. Reviewing the most recent hospital patient data collected by the local college of nursing
• B. Deciding which of several possible new clinic options would be most effective in better meeting the needs of the local community
• C. Evaluating the results of the most recent community-wide screening program before planning for the next community health program
• D. Giving testimony to the state legislature on a new health and safety bill

Correct answer: A

Rationale: The most easily postponed task among the options provided is reviewing the most recent hospital patient data collected by the local college of nursing. This task focuses on data collection and analysis, which can be delayed without immediate impact on decision-making related to new clinic options, community-wide screening program evaluation, or legislative testimony on health and safety bills.

3. Fee-for-service care is best characterized by which statement:

• A. Fees are scaled based on the patient’s ability to pay and are capped.
• B. Fees reflect the fair market value of health care services being provided.
• C. Adequate fee schedules enable hospitals and clinics to function properly.
• D. Fees are not uniform throughout most states as they are fairly unregulated.

Correct answer: D

Rationale: Fee-for-service care is a payment model where providers are paid for each service performed, leading to non-uniform fees that vary by service and provider. This system is not highly regulated, resulting in differing fee structures across states and regions. Therefore, the statement that 'Fees are not uniform throughout most states as they are fairly unregulated' best characterizes fee-for-service care.

4. You are preparing a patient for surgery and completing the preoperative checklist. Which of the following is not typically part of the preoperative checklist?

• A. Assessing for allergies
• B. Conducting the Time Out
• C. Ensuring that informed consent is signed
• D. Ensuring that the history and physical examination have been completed

Correct answer: B

Rationale: Conducting the Time Out is a crucial safety step that occurs immediately before the start of the procedure, but it is not usually part of the preoperative checklist. The Time Out involves verifying patient identity, correct procedure, correct site, and addressing any concerns or questions with the surgical team before proceeding. The other options, such as assessing for allergies, ensuring informed consent, and completing the history and physical examination, are typically included in the preoperative checklist to ensure patient safety and readiness for surgery.

5. The community health nurse is involved in public health work. Which of these statements by the nurse reflects an understanding of upstream interventions?

• A. I will engage in policy initiatives in my urban area.
• B. I will administer the flu shot to interested seniors.
• C. I will help manage a senior's diabetes needs at home.
• D. I will work with a local school to provide asthma education.

Correct answer: A

Rationale: The correct answer is A because engaging in policy initiatives reflects an understanding of upstream interventions. Upstream interventions focus on influencing broader determinants of health, such as policies and social factors, to prevent health issues before they occur. This approach addresses the root causes of health problems rather than just treating symptoms or providing individual care.

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