Nursing Elites

1. 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.

2. When is the time to make people think about the routines that have been previously followed and to consider what might be a better plan of action?

• A. Collection of data
• B. Planning
• C. Analyzing data
• D. Identification

Correct answer: B

Rationale: The correct answer is B, 'Planning.' Planning is the phase where individuals reflect on current routines and explore alternative courses of action. This stage involves considering new strategies and approaches, making it the most suitable time to challenge existing norms. Choice A, 'Collection of data,' focuses on gathering information rather than actively reconsidering routines. Choice C, 'Analyzing data,' involves assessing the gathered data rather than proposing new plans. Choice D, 'Identification,' does not specifically address the process of reviewing routines and suggesting improvements, making it less relevant to the question.

3. After working at your job for 10 months and feeling unable to tolerate the tension and stress between staff nurses and the laissez-faire nurse manager who is not a leader, what is the best course of action?

• A. Submit a resignation and leave within 30 days.
• B. Complain to staff about the nurse manager.
• C. Seek another position within the healthcare organization and apply for a transfer.
• D. Inform the chief nursing officer that you are leaving and explain your dissatisfaction with the lack of leadership.

Correct answer: C

Rationale: In this situation, it is best to seek another position within the healthcare organization and apply for a transfer. Making professional decisions should involve careful evaluation and consideration. It is important to align personal values with the organizational culture. By seeking advice from a mentor or counselor, you can gain valuable insights and consider different perspectives. Resigning abruptly, complaining to staff, or informing the chief nursing officer without exploring other options may not be the most effective or professional approach in this scenario.

4. Which of the following types of HMOs (Health Maintenance Organizations) contracts with two or more IPAs (Independent Practice Associations)?

• A. Staff model
• B. Point of service model
• C. Network model
• D. Group model

Correct answer: C

Rationale: The correct answer is C, the Network model. This type of HMO contracts with two or more IPAs. In a Network model, multiple IPAs work together to provide healthcare services to the members. Choice A, the Staff model, involves physicians who are employees of the HMO. Choice B, the Point of Service model, allows members to seek care outside the network at a higher cost. Choice D, the Group model, does not specifically contract with IPAs.

5. While caring for a client with tuberculosis, which of the following actions should the nurse take?

• A. Use antimicrobial sanitizer for hand hygiene.
• B. Wear a surgical mask when providing client care.
• C. Limit each visitor to 2-hour increments.
• D. Wear gloves when assisting the client with oral care.

Correct answer: A

Rationale: The correct action for the nurse to take when caring for a client with tuberculosis is to use antimicrobial sanitizer for hand hygiene. Tuberculosis is primarily spread through the air, so wearing a surgical mask when providing care (choice B) would be more appropriate for diseases transmitted via droplets. Limiting visitors (choice C) and wearing gloves for oral care (choice D) are important infection control measures but are not specifically tailored to tuberculosis transmission.

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