Nursing Elites

1. 1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?

• A. Blood pressure
• B. Serum creatinine
• C. Chest x-ray
• D. Urine for microalbuminuria

Correct answer: C

Rationale: The correct answer is C: Chest x-ray. While monitoring for complications in a patient with type 2 diabetes, annual tests such as blood pressure measurement, serum creatinine levels, and urine for microalbuminuria are essential. These tests help in assessing kidney function, cardiovascular health, and early signs of kidney damage, which are common complications of diabetes. A chest x-ray is not routinely scheduled annually to monitor for complications related to type 2 diabetes, making it the least applicable option.

2. Quality management and benchmarking are two approaches used to improve the quality of care. The major difference between these two approaches is which of the following?

• A. Quality management is not useful in the outpatient setting
• B. Benchmarking compares outcomes in a variety of settings and disciplines
• C. Quality management is used only in the primary care setting
• D. Benchmarking looks only at outcomes specific to nursing

Correct answer: B

Rationale: The major difference between quality management and benchmarking is that benchmarking compares outcomes in a variety of settings and disciplines. Choice A is incorrect because quality management can be applied in both inpatient and outpatient settings. Choice C is incorrect as quality management is not limited to primary care and can be implemented across various healthcare settings. Choice D is incorrect as benchmarking does not solely focus on nursing outcomes but rather compares outcomes across different disciplines and settings.

3. A nurse is planning an educational program for a group of older adults at a senior living center. Which of the following recommendations should the nurse include?

• A. You should receive a pneumococcal vaccine when you are 65 years old.
• B. You should receive a shingles vaccine when you are 70 years old.
• C. You should receive a tetanus booster every 5 years.
• D. You should have an eye examination every 2 years.

Correct answer: A

Rationale: The correct answer is A. The CDC recommends a pneumococcal vaccine for all adults aged 65 years and older. This vaccine helps protect against serious pneumococcal disease. Choice B is incorrect as the shingles vaccine is recommended for adults aged 50 years and older, not specifically at 70 years. Choice C is incorrect because a tetanus booster is recommended every 10 years, not every 5 years. Choice D is incorrect as the general recommendation for eye examinations in older adults is annually, not every 2 years.

4. 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.

5. The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select all that apply.)

• A. Expected length of stay
• B. Assigned healthcare team
• C. Patient outcomes
• D. Medical history

Correct answer: C

Rationale: In developing a critical pathway for congestive heart failure (CHF), it is essential to include patient outcomes. Patient outcomes help guide the care plan and ensure that interventions are effective. The expected length of stay is crucial to plan for resources but is not directly related to the critical pathway components. While the assigned healthcare team is important for care delivery, it is not a standard component of a critical pathway. Medical history is valuable for understanding the patient's background but is not a core component of a critical pathway.

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