Nursing Elites

1. A client discharges AMA (against medical advice). This is an example of the _________ type of risk category?

• A. nurse-focused
• B. physician-focused
• C. medical-legal incident
• D. Patient-focused

Correct answer: C

Rationale: When a client discharges AMA, it falls under the medical-legal incident risk category. This choice focuses on the legal aspect of the situation, as it involves the patient's right to make decisions about their care, informed consent, and the associated legal implications. Choices A and B are incorrect as they unnecessarily specify individual healthcare roles and do not encompass the broader legal implications of discharging against medical advice. Choice D, patient-focused, is also incorrect as it doesn't capture the legal and risk-related aspects of the scenario.

2. 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.

3. Which level in Maslow's hierarchy is rarely met?

• A. Esteem
• B. Safety
• C. Self-actualization
• D. Belongingness

Correct answer: C

Rationale: The correct answer is C, 'Self-actualization.' Self-actualization, the highest level in Maslow's hierarchy, involves developing one's full potential and achieving personal growth. It is considered rarely met because it requires a deep understanding of oneself, a strong sense of purpose, and the ability to pursue intrinsic goals. Esteem (choice A) focuses on respect, recognition, and self-esteem, which are more commonly achieved than self-actualization. Safety (choice B) and belongingness (choice D) are also more commonly attained as they relate to basic needs for security and social connections, which are essential for overall well-being.

4. A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to

• A.
• B. ask that diagnostic testing area staff to start a 5% dextrose IV
• C. send a glass of milk or orange juice to the patient in the diagnostic testing area
• D. request that if testing is further delayed, the patient be returned to the unit to eat.

Correct answer: D

Rationale:

5. Which of the following types of HMOs (Health Maintenance Organizations) 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, the Network model. This type of HMO contracts with two or more IPAs. In a Network model, multiple IPAs work together to provide healthcare services to the members. Choice A, the Staff model, involves physicians who are employees of the HMO. Choice B, the Point of Service model, allows members to seek care outside the network at a higher cost. Choice D, the Group model, does not specifically contract with IPAs.

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