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1. Which type of HMO contracts with two or more IPAs (Independent Practice Associations)?
- A. Staff model
- B. Point of service model
- C. Network model
- D. Group model
Correct answer: C
Rationale: The correct answer is C: Network model. A network model of HMOs contracts with two or more IPAs. In a network model, the HMO contracts with multiple IPAs to provide healthcare services to its members, offering a wider range of choices and flexibility in selecting healthcare providers. Choices A, B, and D are incorrect because the staff model involves employing physicians and healthcare providers directly, the point of service model allows members to seek care both in-network and out-of-network, and the group model is not specifically associated with contracting IPAs.
2. A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?
- A. Amitriptyline decreases the depression caused by your foot pain.
- B. Amitriptyline helps prevent transmission of pain impulses to the brain.
- C. Amitriptyline corrects some of the blood vessel changes that cause pain.
- D. Amitriptyline improves sleep and reduces awareness of nighttime pain.
Correct answer: B
Rationale: The correct answer is B. Amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, which helps in reducing the transmission of pain impulses to the brain. Choice A is incorrect because amitriptyline primarily works on pain transmission rather than directly on depression. Choice C is inaccurate as amitriptyline's mechanism of action is not related to correcting blood vessel changes. Choice D is partially true as amitriptyline can improve sleep, but the primary mechanism related to pain relief is by preventing pain impulses from reaching the brain.
3. A nurse has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?
- A. The client reports relief of nausea.
- B. The tube aspirate has a pH less than 5.
- C. Bowel sounds are present on auscultation.
- D. An x-ray shows the end of the tube above the pylorus.
Correct answer: A
Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.
4. Which regulatory body mandates the provision of immunizations, especially for hepatitis B?
- A. American Nurses Association (ANA)
- B. Occupational Safety and Health Administration (OSHA)
- C. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
- D. State board of nursing
Correct answer: B
Rationale: The correct answer is B - Occupational Safety and Health Administration (OSHA). OSHA mandates that the hepatitis B vaccine series must be offered to healthcare workers who are not immune to hepatitis. This requirement aims to protect healthcare workers from occupational exposure to bloodborne pathogens, including the hepatitis B virus. The American Nurses Association (ANA) (Choice A) is a professional organization for nurses, not a regulatory body. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (Choice C) focuses on accrediting healthcare organizations for quality and safety, not mandating immunizations. The State board of nursing (Choice D) is responsible for regulating nursing practice within a specific state, not mandating immunizations.
5. During a discussion about the nursing profession at a middle school, which of the following statements is true?
- A. Nurses need to graduate from nursing school to earn a degree.
- B. Nursing is a profession that values continuous education.
- C. Nurses function autonomously within their scope of practice.
- D. Nurses must adhere to professional behaviors in all aspects of their lives.
Correct answer: C
Rationale: The correct answer is C. Nurses are healthcare professionals who can independently make decisions within their defined scope of practice, providing care to patients. This autonomy allows nurses to assess, diagnose, plan, intervene, and evaluate patient care without direct supervision from physicians. Choice A is incorrect because nurses need to graduate from nursing school to earn a degree, not necessarily to obtain a license. Choice B is incorrect because while continuous education is important in nursing, it is not a defining characteristic of the profession. Choice D is incorrect because while nurses are expected to adhere to professional behaviors, it is not limited to their professional lives but extends to their personal lives as well.
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