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. Integrated health care systems function in a variety of models. Which of the following is a common characteristic of all systems?

• A. Deliver selective care only
• B. Deliver a whole continuum of care
• C. Treat patients only in the hospital
• D. Provide care only in the primary care setting

Correct answer: B

Rationale: Integrated health care systems are designed to provide a whole continuum of care, which includes preventive, primary, specialty, hospital, and long-term care services. This integration ensures that patients receive comprehensive and coordinated care across different healthcare settings. Choice A is incorrect because integrated systems aim to provide a wide range of services, not selective care only. Choice C is incorrect as integrated systems extend care beyond hospital settings. Choice D is incorrect as these systems offer care across various settings, not limited to primary care only.

3. Healthcare systems primarily have functional structures. Which of the following would be an example of this?

• A. Open communication exists between Physical Therapy and Nursing.
• B. Medicine has authority over nursing.
• C. Laboratory services have little authority.
• D. All nursing tasks fall under nursing service.

Correct answer: D

Rationale: The correct answer is D. In functional structures, employees are grouped in departments by specialty, with similar tasks being performed by the same group. This means that in a healthcare system with a functional structure, all nursing tasks would fall under the nursing service. Choices A, B, and C are incorrect because open communication between departments, one department having authority over another, or the level of authority of a particular department do not necessarily represent a functional structure.

4. While caring for a client with tuberculosis, which of the following actions should the nurse take?

• A. Use antimicrobial sanitizer for hand hygiene.
• B. Wear a surgical mask when providing client care.
• C. Limit each visitor to 2-hour increments.
• D. Wear gloves when assisting the client with oral care.

Correct answer: A

Rationale: The correct action for the nurse to take when caring for a client with tuberculosis is to use antimicrobial sanitizer for hand hygiene. Tuberculosis is primarily spread through the air, so wearing a surgical mask when providing care (choice B) would be more appropriate for diseases transmitted via droplets. Limiting visitors (choice C) and wearing gloves for oral care (choice D) are important infection control measures but are not specifically tailored to tuberculosis transmission.

5. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: A DNR order can be written after the health-care provider has discussed it with the client and family.

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