Nursing Elites

1. Fee-for-service care is best characterized by which statement:

• A. Fees are scaled based on the patient’s ability to pay and are capped.
• B. Fees reflect the fair market value of health care services being provided.
• C. Adequate fee schedules enable hospitals and clinics to function properly.
• D. Fees are not uniform throughout most states as they are fairly unregulated.

Correct answer: D

Rationale: Fee-for-service care is a payment model where providers are paid for each service performed, leading to non-uniform fees that vary by service and provider. This system is not highly regulated, resulting in differing fee structures across states and regions. Therefore, the statement that 'Fees are not uniform throughout most states as they are fairly unregulated' best characterizes fee-for-service care.

2. Which sign or reflex is used to diagnose meningitis?

• A. Homan's sign
• B. Brudzinski
• C. Startle
• D. Anterior drawer

Correct answer: B

Rationale: Brudzinski sign is a physical exam finding used to diagnose meningitis. It is elicited by flexing the patient's neck, resulting in involuntary flexion of the hips and knees. This maneuver indicates meningeal irritation, a common feature in meningitis. Homan's sign is used to assess for deep vein thrombosis, Startle is a reflex response to sudden stimuli, and the Anterior drawer test is used to diagnose ligamentous instability in the knee.

3. How should a healthcare provider determine a client’s reading level?

• A. Ask the client how they would rate their ability to read.
• B. Have the client assess their own health literacy and provide examples.
• C. Determine the client's completed years of formal education.
• D. Utilize literacy assessment tools available in the literature.

Correct answer: A

Rationale: In assessing a client's reading level, asking the client to rate their own reading ability is a quick and straightforward method. It allows for a self-assessment that may provide insights into the individual's perception of their literacy skills. This approach can be efficient in initiating discussions about reading abilities and can serve as a starting point for further literacy evaluation if needed.

4. Which best describes a primary role of nurses in promoting community health?

• A. Conducting individual health assessments
• B. Advocating for health policy changes
• C. Providing health education to groups
• D. Developing health policies

Correct answer: B

Rationale: A primary role of nurses in promoting community health involves advocating for health policy changes. By advocating for policy changes, nurses can address systemic issues that impact the health of the community as a whole, rather than focusing solely on individual assessments or education. This proactive approach allows nurses to influence broader health determinants and create sustainable improvements in community health outcomes.

5. The public health nurse partners with the American Heart Association to develop NYS public policy priority statements to promote the expansion of the Double Up Food Bucks program. Which area and intervention on the Minnesota Public Health Wheel do these actions most closely align?

• A. Counseling - Blue wedge
• B. Advocacy - Yellow wedge
• C. Outreach - Red wedge
• D. Screening - Red wedge

Correct answer: B

Rationale: In this scenario, the public health nurse is engaging in advocacy by partnering with an organization to influence public policy through the development of public policy priority statements. Advocacy, represented by the yellow wedge on the Minnesota Public Health Wheel, aligns most closely with these actions as it involves working to influence public policy.

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