Nursing Elites

1. While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.

• A. Parallel
• B. Functional
• C. Service-integrated
• D. Matrix

Correct answer: B

Rationale: The correct answer is B: Functional. In functional structures, employees are grouped into departments based on specialty, allowing individuals with similar skills and tasks to work together efficiently. In this scenario, organizing the hospital into departments such as nursing, dietary, and pharmacy based on their specialties exemplifies a functional organizational structure. Choice A, Parallel structure, involves independent units working on similar tasks, which is not the case here. Choice C, Service-integrated structure, emphasizes cross-functional teamwork across various departments, which is not the main focus in the scenario. Choice D, Matrix structure, involves employees reporting to multiple managers for different projects or tasks, which is not described in the scenario.

2. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?

• A. Teach the patient about administering regular insulin.
• B. Schedule the patient for a fasting blood glucose level.
• C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
• D. Provide teaching about an increased risk for fetal problems with gestational diabetes.

Correct answer: B

Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.

3. When planning a budget, the nurse manager knows that costs depend on and change in direct proportion to patient volume and activity. What type of costs are these?

• A. Variable costs
• B. Indirect costs
• C. Fixed costs
• D. Direct costs

Correct answer: A

Rationale: Variable costs vary in direct proportion to patient volume and activity. These costs increase or decrease based on the level of patient care provided. Indirect costs are not directly tied to patient volume, fixed costs remain constant regardless of patient volume, and direct costs are directly attributable to patient care but may not vary with patient volume and activity. Therefore, the correct answer is 'Variable costs.'

4. Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)

• A. Notify the nursing supervisor.
• B. Notify security.
• C. Have them check patients to verify safety.
• D. Ask construction workers to be responsible.

Correct answer: D

Rationale: When construction is ongoing in a healthcare setting, it is essential to address safety concerns promptly. While it is crucial to notify the nursing supervisor and security to manage potential risks, having staff check patients for safety is also a valid precautionary measure. However, asking construction workers to be responsible is not a proper action to address the safety concerns posed by the equipment. Construction workers are professionals responsible for their tasks; it is the healthcare facility's responsibility to ensure patient and staff safety in such situations.

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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