Nursing Elites

1. The new graduate nurse interviews for a position in a nursing department of a large health care agency, described by the interviewer as having shared governance. Which of these statements best illustrates the shared governance model?

• A. An appointed board oversees any administrative decisions
• B. Nursing departments share responsibility for client outcomes
• C. Staff groups are appointed to discuss nursing practice and client education issues
• D. Non-nurse managers supervise nursing staff in groups of units

Correct answer: B

Rationale: The correct answer is B because shared governance involves nurses and other staff sharing responsibility for decisions related to patient care and outcomes, promoting collaborative practice and shared accountability. Choice A is incorrect as shared governance includes active participation of frontline staff, not just an appointed board. Choice C is incorrect because shared governance goes beyond just discussing issues to actively sharing responsibility for decision-making. Choice D is incorrect as shared governance encourages nurses to have a significant role in decision-making rather than being supervised by non-nurse managers.

2. The nurse working in a community health clinic that serves recent Somali immigrants notes that most mothers refuse to give permission for routine immunizations of their preschoolers. Which individual is likely to have the most influence on these women's perceptions about their children's healthcare needs?

• A. husbands
• B. clinic healthcare providers
• C. older females
• D. tribal chief

Correct answer: D

Rationale: In many Somali communities, the tribal chief holds significant influence over health decisions. The tribal chief often plays a crucial role in shaping community beliefs and practices, including healthcare decisions. While husbands may have some influence, the tribal chief typically holds more authority in community matters. Clinic healthcare providers have a role in educating and advising, but the tribal chief's influence is often more profound in this cultural context. Older females may have some influence, especially in familial matters, but the tribal chief is usually the key decision-maker in community health issues.

3. As a community health nurse covering a cluster of Barangays, your population coverage includes the following:

• A. Families in their homes, School population, Workers in factories
• B. Families in their homes, School population, Patients in hospital
• C. All except workers in factories
• D. All except patients in hospital

Correct answer: A

Rationale: The correct answer is A: 'Families in their homes, School population, Workers in factories.' As a community health nurse, you are responsible for providing healthcare services and promoting health within the community. This includes visiting families in their homes to assess their health needs, working with the school population to educate them on preventive health measures, and ensuring the health and safety of workers in factories. Choices B, C, and D are incorrect because they do not encompass the full scope of a community health nurse's responsibilities. Choice B does not include workers in factories, Choice C excludes an important population group, and Choice D excludes an essential setting where healthcare services are provided.

4. In providing comprehensive family health care, the nurse utilizes four (4) basic processes. These are listed in the order in which they are carried out as follows:

• A. assessment, planning, intervention, and evaluation
• B. assessment, intervention, planning, and evaluation
• C. planning, assessment, intervention, and evaluation
• D. planning, intervention, evaluation, and assessment

Correct answer: A

Rationale: The correct order for the basic processes in providing comprehensive family health care is assessment, planning, intervention, and evaluation. Assessment is the first step to gather information, followed by planning to set goals and strategies, then intervention to implement the plan, and finally evaluation to assess the outcomes. Choice A is correct as it follows this logical sequence. Choices B, C, and D are incorrect because they do not follow the correct order of these essential processes in nursing care.

5. During a large community disaster, a man states that the blast threw him out of a second-story window. Which action should the nurse implement first?

• A. Logroll the client to his side and assess for back injuries
• B. Perform a complete neurological assessment
• C. Open the client's airway immediately
• D. Place the nurse's hands around the client's neck to stabilize

Correct answer: D

Rationale: In this situation, the nurse should first stabilize the client's neck to prevent potential spinal cord injuries. Logrolling the client or performing other assessments should only be done after ensuring spinal stabilization. Opening the airway immediately is important in cases of airway obstruction, but stabilizing the neck takes priority in this scenario. Performing a complete neurological assessment may delay immediate stabilization, which is crucial in suspected spinal injuries.

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