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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. Which theory emphasizes the long-range plan rather than rewards?
- A. Equity theory.
- B. Development.
- C. Goal setting.
- D. Extinction.
Correct answer: C
Rationale: The correct answer is C, Goal setting. Goal-setting theory emphasizes that it is the goal itself that motivates a person to exert effort, not just the rewards or outcomes. This theory focuses on setting specific and challenging goals to enhance performance. Choices A, B, and D are incorrect because Equity theory relates to fairness in social exchanges, Development theory concerns personal growth and advancement, and Extinction refers to the disappearance of a behavior when it is no longer reinforced.
3. One of the steps in coaching is often overlooked and taken for granted. What is this step?
- A. Stating the target
- B. Jumping to conclusions
- C. Asking for suggestions
- D. Tying the problem to clients' care
Correct answer: D
Rationale: In coaching, tying the problem to clients' care is crucial but often overlooked. This step ensures that the coach and the client focus on issues directly impacting the client's well-being. Stating the target (choice A) is important but not as critical as tying the problem to clients' care. Jumping to conclusions (choice B) is counterproductive in coaching as it may lead to incorrect assumptions. Asking for suggestions (choice C) is valuable, but it does not address the core aspect of linking the issue to the client's care, which is essential for effective coaching.
4. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to
- A. use only the lispro insulin until the symptoms are resolved
- B. limit calorie intake until the glucose is less than 120 mg/dL
- C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
- D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%
Correct answer: C
Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.
5. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?
- A. Measure the ankle-brachial index.
- B. Check for changes in skin pigmentation.
- C. Assess for unilateral or bilateral foot drop.
- D. Ask the patient about symptoms of depression.
Correct answer: A
Rationale: The correct answer is A: Measure the ankle-brachial index. This task involves using a Doppler ultrasound device to assess blood flow, which can be safely delegated to UAP. Choices B, C, and D require a higher level of assessment and interpretation that should be performed by licensed nursing staff. Checking for changes in skin pigmentation (B) and assessing for foot drop (C) involve more complex assessments that require nursing judgment. Asking about symptoms of depression (D) involves a psychosocial assessment, which should be performed by licensed personnel qualified to address mental health concerns.
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