Nursing Elites

1. Which regulatory body mandates the provision of immunizations, especially for hepatitis B?

• A. American Nurses Association (ANA)
• B. Occupational Safety and Health Administration (OSHA)
• C. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
• D. State board of nursing

Correct answer: B

Rationale: The correct answer is B - Occupational Safety and Health Administration (OSHA). OSHA mandates that the hepatitis B vaccine series must be offered to healthcare workers who are not immune to hepatitis. This requirement aims to protect healthcare workers from occupational exposure to bloodborne pathogens, including the hepatitis B virus. The American Nurses Association (ANA) (Choice A) is a professional organization for nurses, not a regulatory body. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (Choice C) focuses on accrediting healthcare organizations for quality and safety, not mandating immunizations. The State board of nursing (Choice D) is responsible for regulating nursing practice within a specific state, not mandating immunizations.

2. Quality management and benchmarking are two approaches used to improve the quality of care. The major difference between these two approaches is which of the following?

• A. Quality management is not useful in the outpatient setting
• B. Benchmarking compares outcomes in a variety of settings and disciplines
• C. Quality management is used only in the primary care setting
• D. Benchmarking looks only at outcomes specific to nursing

Correct answer: B

Rationale: The major difference between quality management and benchmarking is that benchmarking compares outcomes in a variety of settings and disciplines. Choice A is incorrect because quality management can be applied in both inpatient and outpatient settings. Choice C is incorrect as quality management is not limited to primary care and can be implemented across various healthcare settings. Choice D is incorrect as benchmarking does not solely focus on nursing outcomes but rather compares outcomes across different disciplines and settings.

3. Within the fast-paced, changing healthcare environment, job satisfaction will influence your success. What other characteristic is an asset?

• A. Being friendly
• B. Humility
• C. Ability to anticipate consequences
• D. Flexibility

Correct answer: D

Rationale: In the fast-paced and evolving healthcare setting, flexibility is a crucial asset. Shaffer (2006) emphasizes the importance of being adaptable to change for professional growth. While being friendly and having humility are positive traits, they may not directly address the need to adapt to the dynamic healthcare environment. Anticipating consequences is valuable but may not encompass the breadth of skills needed to navigate rapid changes effectively.

4. For a 55-year-old female patient with type 2 diabetes and a nursing diagnosis of imbalanced nutrition: more than body requirements, which goal is most important?

• A. The patient will reach a glycosylated hemoglobin level of less than 7%.
• B. The patient will follow a diet and exercise plan that results in weight loss.
• C. The patient will choose a diet that distributes calories throughout the day.
• D. The patient will state the reasons for eliminating simple sugars in the diet.

Correct answer: A

Rationale: The most important goal for a 55-year-old female patient with type 2 diabetes and imbalanced nutrition due to more than body requirements is to reach a glycosylated hemoglobin level of less than 7%. This goal directly addresses the management of diabetes and is crucial in preventing complications associated with high blood sugar levels. Choice B focuses on weight loss, which may be beneficial but is not as critical as controlling blood sugar levels. Choice C, distributing calories throughout the day, is important for glycemic control but not as immediate as reaching a target HbA1c level. Choice D, stating the reasons for eliminating simple sugars, is a good educational goal but not as urgent as achieving glycemic control.

5. During a staffing crisis, managers may need to use nurse extenders. These individuals are better known as:

• A. Float RNs.
• B. Unlicensed assistive personnel.
• C. LPNs.
• D. Agency nurses.

Correct answer: B

Rationale: During a staffing crisis, managers may need to utilize unlicensed assistive personnel (UAPs) as nurse extenders. UAPs help free up nurses' time, enabling them to focus more on direct client care. Float RNs (Choice A) refer to registered nurses who work in various units as needed, not specifically as nurse extenders during crises. LPNs (Choice C) are licensed practical nurses, not typically used as nurse extenders. Agency nurses (Choice D) are temporary nurses hired from external agencies, not necessarily designated as nurse extenders.

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