Nursing Elites

1. Which of the following would a nurse suggest are significant benefits to an organization that is considering adoption of a practice partnership model? (Select one that does not apply.)

• A. Clients express greater satisfaction.
• B. It is more expensive to implement than other models.
• C. Continuity of care is facilitated.
• D. Leadership is well accepted.

Correct answer: B

Rationale: The correct answer is B. Practice partnership models are shown to be the most cost-effective of the nursing care delivery systems, contrary to being more expensive. Clients express greater satisfaction due to the collaborative and holistic approach of this model. Continuity of care is improved when the healthcare team works together cohesively. While leadership acceptance is beneficial, it is not the most significant benefit highlighted in the context of practice partnership models.

2. After receiving change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who has a hemoglobin A1C of 12%
• B. 23-year-old with type 1 diabetes who has a blood glucose of 40 mg/dL
• C. 40-year-old who is pregnant and has an oral glucose tolerance test result of 202 mg/dL
• D. 50-year-old who uses exenatide (Byetta) and is complaining of acute abdominal pain

Correct answer: B

Rationale: The correct answer is B because the patient with a blood glucose level of 40 mg/dL (hypoglycemia) needs immediate attention. Hypoglycemia is an emergency situation that requires prompt intervention to prevent adverse effects such as seizures or loss of consciousness. Assessing and managing this patient first is crucial to prevent further deterioration. Choices A, C, and D do not present immediate life-threatening situations requiring urgent intervention like severe hypoglycemia does. While a high hemoglobin A1C level (choice A), an abnormal oral glucose tolerance test result (choice C), and acute abdominal pain (choice D) are important issues, they do not pose an immediate threat to the patient's life compared to severe hypoglycemia.

3. In the traditional rating scale, what is the time period typically used for evaluation?

• A. Twelve months
• B. Six months
• C. Three months
• D. One month

Correct answer: A

Rationale: In the traditional rating scale, evaluations are typically conducted over a 12-month period. This duration allows for a comprehensive assessment of the employee's performance and progress throughout the year, capturing a broader range of experiences and accomplishments to provide a more holistic evaluation. Choices B, C, and D are incorrect because they do not align with the standard practice of conducting annual evaluations in a traditional rating scale setting.

4. A nurse manager wants to implement a new policy on the unit. What is the first step in the change process according to Lewin's Change Theory?

• A. Unfreeze the system
• B. Move the system to a new level
• C. Refreeze the system
• D. Evaluate the system

Correct answer: A

Rationale: The correct answer is A: 'Unfreeze the system.' According to Lewin's Change Theory, unfreezing the system is the initial step in the change process. This step involves preparing the organization for change by creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Choice B, 'Move the system to a new level,' is incorrect as it does not align with the first step of unfreezing. Choice C, 'Refreeze the system,' is incorrect as it pertains to the final stage of solidifying the change, not the first step. Choice D, 'Evaluate the system,' is incorrect as evaluation typically occurs after the change has been implemented, not at the beginning of the change process.

5. The staff in the emergency department has presented the nurse leader with a suggestion for streamlining the triage process, cutting down on wait times. Which of the following qualities does the leader specifically need to implement the suggestion?

• A. Courage
• B. Integrity
• C. Energy
• D. Initiative

Correct answer: D

Rationale: Initiative is the correct quality needed in this situation. The staff has provided a suggestion for improvement, and the leader must take the initiative to implement it. Courage, integrity, and energy are valuable qualities as well but in this context, the most essential quality is initiative to drive the change forward and improve the triage process efficiently.

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