Nursing Elites

1. What title should be given to this occupational health nurse job description? A registered nurse who establishes a provider network, recommends treatment plans that assure quality and efficacy while controlling costs, monitors outcomes, and maintains communication among all involved.

• A. manager
• B. researcher
• C. case manager
• D. health promotion specialist

Correct answer: C

Rationale: The correct answer is C: case manager. A case manager in healthcare coordinates care, monitors outcomes, and ensures quality and cost-effectiveness. In this job description, the nurse is mainly focused on coordinating care, recommending treatment plans, monitoring outcomes, and maintaining communication among all involved, which aligns with the responsibilities of a case manager. Choices A, B, and D are incorrect because the job description does not primarily involve general management, research, or health promotion specialization.

2. The community health nurse is planning a series of educational courses about the healthcare system and meeting healthcare needs for the community center. Which adjunct issue should the nurse address for a group of older adults?

• A. Peer concerns.
• B. Adult daycare.
• C. Retirement issues.
• D. Vocational concerns.

Correct answer: B

Rationale: When planning educational courses for older adults, addressing adult daycare is crucial as it is a relevant issue that can impact their daily lives and access to healthcare services. Peer concerns may not be directly related to healthcare needs, retirement issues are important but not as immediate in terms of healthcare access, and vocational concerns are more pertinent to working-age individuals.

3. The nurse is working in a community health clinic that serves a diverse population. Which of the following actions best demonstrates cultural competence?

• A. Learning about the cultural practices of the clinic's client population
• B. Providing translation services for non-English speaking clients
• C. Treating all clients the same regardless of their background
• D. Encouraging clients to adopt mainstream health practices

Correct answer: A

Rationale: Learning about the cultural practices of the clinic's client population is the best way to demonstrate cultural competence. This action shows respect for the diverse backgrounds of the clients and helps in providing care that is sensitive to their cultural beliefs and practices. Providing translation services (Choice B) is important for effective communication but may not address the deeper aspects of cultural competence. Treating all clients the same (Choice C) may overlook the unique needs that arise from cultural differences. Encouraging clients to adopt mainstream health practices (Choice D) may not be appropriate or respectful of their cultural traditions and preferences.

4. A nurse manager is using the technique of brainstorming to help solve a problem. One nurse criticizes another nurse’s contribution and begins to find objections to the suggestion. The nurse manager's best response is to

• A. Let’s move on to a new action that deals with the problem.
• B. I think you need to reserve judgment until after all suggestions are offered.
• C. Very well thought out. Your analytic skills and interest are incredible.
• D. Let’s move to the ‘what if…’ as related to these objections for an exploration of spin-off ideas.

Correct answer: D

Rationale: Encouraging the group to explore 'what if' scenarios based on the objections helps to maintain a positive and creative brainstorming atmosphere, while also validating the concerns raised by the nurse. Choice A is dismissive and does not address the issue at hand. Choice B suggests postponing judgment, which may not resolve the tension caused by the criticism. Choice C is complimentary but does not address the critical feedback provided by the nurse, missing an opportunity to turn objections into opportunities for further exploration.

5. While caring for the client during the first hour after delivery, the nurse determines that the uterus is boggy and there is vaginal bleeding. What should be the nurse's first action?

• A. Check vital signs
• B. Massage the fundus
• C. Offer a bedpan
• D. Check for perineal lacerations

Correct answer: B

Rationale: The correct action for the nurse to take when encountering a boggy uterus and vaginal bleeding after delivery is to massage the fundus. Massaging the fundus helps the uterus contract, which can reduce vaginal bleeding. Checking vital signs may be important but addressing the uterine atony and bleeding takes precedence. Offering a bedpan or checking for perineal lacerations are not the immediate actions needed to manage postpartum hemorrhage.

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