Nursing Elites

1. Which of the following is an example of a macro-level health policy?

• A. Local health ordinances
• B. State licensing regulations
• C. National healthcare legislation
• D. Institutional policies

Correct answer: C

Rationale: The correct answer is national healthcare legislation. This type of policy operates at a broad level, influencing healthcare delivery and financing across an entire nation. It sets overarching frameworks and regulations that impact various aspects of the healthcare system on a large scale, affecting a wide population rather than specific localities or institutions. Choices A, B, and D are not examples of macro-level health policy. Local health ordinances pertain to specific areas or communities, state licensing regulations focus on a state level, and institutional policies are internal regulations of a particular healthcare facility.

2. Which of the following is a common characteristic of a high reliability organization (HRO)?

• A. Flexibility
• B. Reluctance to simplify
• C. Preoccupation with failure
• D. Deference to expertise

Correct answer: C

Rationale: A common characteristic of a high reliability organization (HRO) is a preoccupation with failure. HROs focus on identifying and addressing potential failure points to prevent errors and maintain high levels of safety and reliability. This mindset helps them anticipate and mitigate risks proactively, leading to better outcomes and performance. Choices A, B, and D are incorrect. While flexibility, reluctance to simplify, and deference to expertise may be important in various contexts, they are not the primary defining characteristics of a high reliability organization. The core focus of HROs is on continuously monitoring for potential failures and working to prevent them.

3. A client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?

• A. Continuous quality improvement
• B. Total quality management
• C. Six Sigma
• D. Quality management

Correct answer: B

Rationale: Total Quality Management (TQM) emphasizes meeting customer needs and satisfaction. In this scenario, by honoring the client's request to delay care to allow for rest, the nurse is aligning with the customer-focused approach of TQM. TQM seeks to continuously improve processes and services to enhance customer experiences and outcomes. Continuous Quality Improvement focuses on incremental improvements in processes and outcomes over time. Six Sigma is a data-driven approach to process improvement that aims to reduce defects and errors. Quality Management is a broader concept that encompasses various strategies to ensure quality standards are met.

4. 1. Which patient action indicates good understanding of the nurse�s teaching about administration of aspart (NovoLog) insulin?

• A. The patient avoids injecting the insulin into the upper abdominal area
• B. The patient cleans the skin with soap and water before insulin administration.
• C. The patient stores the insulin in the freezer after administering the prescribed dose.
• D. The patient pushes the plunger down while removing the syringe from the injection site

Correct answer: B

Rationale:

5. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

• A. The patient always carries hard candies when engaging in exercise.
• B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
• C. The patient has a peanut butter sandwich before going for a bicycle ride.
• D. The patient increases daily exercise when ketones are present in the urine.

Correct answer: D

Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

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