Nursing Elites

1. A nurse is caring for a client who reports difficulty falling asleep. Which of the following recommendations should the nurse make?

• A. Watch a television program in bed before going to sleep.
• B. Drink a cup of hot cocoa before bedtime.
• C. Maintain a consistent time to wake up each day.
• D. Exercise 1 hour before going to bed.

Correct answer: C

Rationale: The correct answer is C: "Maintain a consistent time to wake up each day." Establishing a regular wake-up time helps regulate the body's internal clock and promotes better sleep patterns. Watching television in bed (Choice A) can actually hinder sleep due to the light emitted by screens affecting melatonin production. Drinking beverages with caffeine like hot cocoa (Choice B) close to bedtime can interfere with falling asleep. Exercising vigorously right before bed (Choice D) can increase alertness and make it harder to fall asleep.

2. 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.

3. A staff nurse describes the unit manager as 'a born leader.' The nurse ascribes to which theory of leadership?

• A. Trait theories
• B. Behavioral theories
• C. Formal leadership theories
• D. Democratic leadership theories

Correct answer: A

Rationale: The correct answer is A: Trait theories. The nurse describing the unit manager as 'a born leader' aligns with trait theories of leadership, which suggest that certain inborn characteristics or traits contribute to effective leadership. This theory emphasizes that leaders possess natural qualities that make them suitable for leadership roles. Choices B, C, and D are incorrect. Behavioral theories focus on the actions and behaviors of leaders, formal leadership theories emphasize organizational structure and roles, and democratic leadership theories pertain to a style of leadership that involves participative decision-making.

4. When planning care for a client with vision loss, which of the following interventions should the nurse include in the plan of care to assist the client with feeding?

• A. Arrange food in a consistent pattern on the client's plate
• B. Thicken liquids on the client's tray
• C. Provide small-handled utensils for the client
• D. Assign a staff member to feed the client

Correct answer: A

Rationale: When a client has vision loss, arranging food in a consistent pattern on the plate can help them locate and identify different food items more easily. This intervention promotes independence and allows the client to feed themselves with greater ease. Thicking liquids on the tray, providing small-handled utensils, or assigning a staff member to feed the client may not directly address the client's need for assistance with feeding due to vision loss. Thicking liquids is more related to swallowing difficulties, providing small-handled utensils can be helpful for clients with limited dexterity, and assigning a staff member to feed the client may not promote independence.

5. Which of the following theories best describes current health care delivery systems?

• A. Open system theory
• B. Closed system theory
• C. Chaos theory
• D. Contingency theory

Correct answer: D

Rationale: The contingency theory best describes the current health care delivery systems. Contingency theory emphasizes that there is no one best way to organize or manage, and the effectiveness of an organization is contingent upon internal and external factors. In healthcare, the delivery systems must often adapt and be flexible in response to various factors like patient needs, technological advancements, and regulatory changes. Open system theory focuses on the interaction between a system and its environment, but it does not capture the dynamic and adaptive nature of current healthcare systems. Closed system theory suggests systems are self-contained and do not interact with the environment, which is not accurate for healthcare systems that constantly interact with patients, providers, and external factors. Chaos theory deals with complex systems and unpredictability, which while relevant to some aspects of healthcare, does not provide a comprehensive framework for understanding healthcare delivery systems.

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