Nursing Elites

1. Which of the following theories best describes current health care delivery systems?

• A. Open system theory
• B. Closed system theory
• C. Chaos theory
• D. Contingency theory

Correct answer: D

Rationale: The contingency theory best describes the current health care delivery systems. Contingency theory emphasizes that there is no one best way to organize or manage, and the effectiveness of an organization is contingent upon internal and external factors. In healthcare, the delivery systems must often adapt and be flexible in response to various factors like patient needs, technological advancements, and regulatory changes. Open system theory focuses on the interaction between a system and its environment, but it does not capture the dynamic and adaptive nature of current healthcare systems. Closed system theory suggests systems are self-contained and do not interact with the environment, which is not accurate for healthcare systems that constantly interact with patients, providers, and external factors. Chaos theory deals with complex systems and unpredictability, which while relevant to some aspects of healthcare, does not provide a comprehensive framework for understanding healthcare delivery systems.

2. Which of the following best describes the concept of interprofessional collaboration in healthcare?

• A. The process by which multiple healthcare professionals work together to improve patient outcomes
• B. A method for healthcare professionals to work independently within their scope of practice
• C. The use of standardized protocols to ensure consistent care
• D. A way for healthcare professionals to share patient information electronically

Correct answer: A

Rationale: The correct answer is A. Interprofessional collaboration in healthcare refers to the coordinated efforts of multiple healthcare professionals working together to enhance patient outcomes. This collaborative approach involves professionals from different disciplines contributing their expertise to provide comprehensive care and improve the overall quality of patient treatment. Choice B is incorrect because interprofessional collaboration emphasizes teamwork and collective efforts rather than working independently. Choice C is incorrect as it refers to standardization of care protocols, not collaboration among professionals. Choice D is incorrect as sharing patient information electronically is a component of information exchange but not the primary focus of interprofessional collaboration.

3. After the nurse has finished teaching a patient who has a new prescription for exenatide (Byetta), which patient statement indicates that the teaching has been effective?

• A. “I may feel hungrier than usual when I take this medicine.”
• B. “I will not need to worry about hypoglycemia with the Byetta.”
• C. “I should take my daily aspirin at least an hour before the Byetta.”
• D. “I will take the pill at the same time I eat breakfast in the morning.”

Correct answer: C

Rationale:

4. In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?

• A. First
• B. Second
• C. Third
• D. Fourth

Correct answer: A

Rationale: The correct answer is A: First. In the grievance process, the initial step involves the nurse talking to the nurse manager to address the issue informally. Subsequently, step two entails filing a written appeal to the director of nursing or designee. Step three involves a formal meeting with the employee, agent, grievance chairperson, nursing administrator, and director of human resources. The final step, step four, is arbitration, which is initiated when no mutually acceptable solutions can be reached by the involved parties. Therefore, the nurse talking to the nurse manager about the disagreement is the first step in the grievance process.

5. When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the healthcare provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may

• A. require administration of insulin while taking prednisone
• B. develop acute hypoglycemia while taking prednisone
• C. require administration of insulin while taking prednisone
• D. have rashes caused by metformin-prednisone interactions

Correct answer: C

Rationale: When a patient taking metformin develops an allergic rash from an unknown cause and is prescribed prednisone, the nurse should anticipate that the patient may require administration of insulin while taking prednisone. Prednisone can increase blood glucose levels by antagonizing the effects of insulin, leading to hyperglycemia. Therefore, the patient may need additional insulin to manage blood sugar levels effectively. The other options are incorrect as prednisone would not directly cause a need for a higher-calorie diet, acute hypoglycemia, or rashes caused by a metformin-prednisone interaction.

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