Nursing Elites

1. What is the primary purpose of clinical pathways in healthcare?

• A. Reduce hospital readmissions
• B. Standardize care
• C. Provide individualized care
• D. Streamline care processes

Correct answer: C

Rationale: The primary purpose of clinical pathways in healthcare is to provide individualized care. While clinical pathways do involve standardizing treatment plans, their main goal is to tailor these plans to the individual needs of patients. This customization ensures that patients receive care that is specific to their condition and requirements, rather than a one-size-fits-all approach. Choices A, B, and D are incorrect because although reducing hospital readmissions, standardizing care, and streamlining care processes can be benefits of clinical pathways, they are not the primary purpose. The main focus is on delivering personalized treatment paths to enhance patient outcomes.

2. What is the primary focus of health promotion activities?

• A. To manage chronic diseases
• B. To educate patients about their health
• C. To prevent the onset of disease
• D. To identify and treat diseases early

Correct answer: C

Rationale: The correct answer is C: 'To prevent the onset of disease.' Health promotion activities aim to prevent diseases before they occur by promoting healthy behaviors, lifestyles, and environments. Choice A, 'To manage chronic diseases,' is incorrect as health promotion focuses on prevention rather than management. Choice B, 'To educate patients about their health,' is important but not the primary focus of health promotion. Choice D, 'To identify and treat diseases early,' is related to early detection and treatment, which is different from the primary goal of health promotion.

3. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?

• A. Ask the client to consider a direct donation
• B. Withhold the blood transfusion
• C. Ask the client to consider a direct donation
• D. Request a consultation with the ethics committee

Correct answer: A

Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.

4. An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?

• A. Hemoglobin A1C level 6.2%
• B. Blood pressure 146/88 mmHg
• C. Heart rate at rest 58 beats/minute
• D. High-density lipoprotein (HDL) level 65 mg/dL

Correct answer: B

Rationale: The correct answer is B. In a young adult with type 1 diabetes, a blood pressure of 146/88 mmHg may indicate the need for a change in therapy as it is above the recommended target levels. High blood pressure can increase the risk of cardiovascular complications in diabetic patients. Choices A, C, and D are within normal ranges and do not necessarily indicate the need for an immediate change in therapy. A Hemoglobin A1C level of 6.2% is generally considered good control for a diabetic patient, a resting heart rate of 58 beats/minute is normal for an active individual, and an HDL level of 65 mg/dL is considered to be in the desirable range for heart health.

5. 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.

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