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 is a key component of patient-centered care?

• A. Provider-centered decision making
• B. Timely discharge
• C. Respect for patient preferences
• D. Focusing on clinical outcomes

Correct answer: C

Rationale: The correct answer is C: Respect for patient preferences. Patient-centered care focuses on involving patients in their care decisions and respecting their preferences. Choice A, provider-centered decision making, goes against the concept of patient-centered care as it prioritizes the provider over the patient. Timely discharge, choice B, is important but not a defining component of patient-centered care. Focusing on clinical outcomes, choice D, is essential in healthcare but does not solely represent patient-centered care, which is more about personalized care and involving patients in decision-making.

3. 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.

4. The process by which registered nurses assess and judge the performance of peers against some predetermined standard is called:

• A. Group evaluation.
• B. Peer review.
• C. Forced distribution evaluation.
• D. Essay evaluation.

Correct answer: B

Rationale: The correct answer is B: Peer review. Peer review is a process in which professional peers assess and judge the performance of their colleagues against predetermined standards. Essay evaluations involve describing an employee's performance through a detailed written narrative. Forced distribution evaluation is a method where employees are rated based on a fixed distribution, similar to grading on a curve. Group evaluation, on the other hand, involves managers comparing individual and group performance against organizational standards.

5. What is the main focus of the Six Sigma methodology in healthcare?

• A. Reducing healthcare costs
• B. Improving patient satisfaction
• C. Enhancing clinical decision making
• D. Increasing healthcare access

Correct answer: C

Rationale: The main focus of the Six Sigma methodology in healthcare is enhancing clinical decision making through data-driven approaches. By using statistical methods and quality improvement tools, Six Sigma aims to reduce errors, improve processes, and enhance overall decision-making in healthcare settings. While reducing healthcare costs and improving patient satisfaction are important goals, they are not the primary focus of Six Sigma in healthcare. Increasing healthcare access is also a valuable objective but not the main focus of the Six Sigma methodology.

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