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. A __________ is often helpful to use when a problem is not easily identified.

• A. trial and error
• B. Delphi method
• C. political decision-making model
• D. affinity map

Correct answer: D

Rationale: An affinity map is a tool commonly used when a problem is not easily identified. It helps in organizing and grouping ideas, data, or information based on relationships or themes. Choice A, 'trial and error,' involves repeatedly trying different solutions until the problem is solved, which may not be efficient when the problem is not clearly defined. Choice B, the 'Delphi method,' is a structured communication technique for experts to reach a consensus, not specifically for unidentified problems. Choice C, 'political decision-making model,' refers to a process for making decisions in political contexts and is not directly related to identifying unknown problems.

3. Which of the following presents an important emerging challenge to changes in health care?

• A. Decreased immigration
• B. Nursing staff shortages
• C. Bioterrorism
• D. Increased surgical procedures

Correct answer: C

Rationale: Bioterrorism is considered an important emerging challenge to changes in health care due to its potential to disrupt healthcare systems, cause mass casualties, and create public health emergencies. Choices A, B, and D are not directly related to emerging challenges in health care. While nursing staff shortages are a significant issue, bioterrorism poses a different kind of threat that requires specific preparedness and response strategies.

4. Which information is most important for the nurse to report to the health care provider before a patient with type 2 diabetes is prepared for a coronary angiogram?

• A. The patient’s most recent HbA1C was 6.5%
• B. The patient’s admission blood glucose is 128 mg/dL.
• C. The patient took the prescribed metformin (Glucophage) today
• D. The patient took the prescribed captopril (Capoten) this morning.

Correct answer: C

Rationale:

5. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?

• A. Ask the client to consider a direct donation
• B. Withhold the blood transfusion
• C. Ask the client to consider a direct donation
• D. Request a consultation with the ethics committee

Correct answer: A

Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.

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