Nursing Elites

1. The staff nurse is caring for the client with total accountability and is in continual communication with the client, the family, the physicians, and other members of the health care team. This type of nursing delivery system is known as:

• A. Total patient care
• B. Qualified nurse case managers
• C. Established critical pathways
• D. Quality management system

Correct answer: A

Rationale: The correct answer is A: Total patient care. Total patient care is the original model of nursing care delivery, in which one RN has complete responsibility for all aspects of care for one or more patients. In this system, the nurse is accountable for the client's care and maintains continuous communication with the client, their family, physicians, and other healthcare team members. Choice B, Qualified nurse case managers, refers to nurses who coordinate care but do not provide direct hands-on patient care. Choice C, Established critical pathways, involves predefined care plans for specific conditions but does not imply direct accountability as in total patient care. Choice D, Quality management system, relates to processes to ensure and enhance the quality of care but is not specifically about the direct provision of patient care.

2. A client experiences an air emboli, resulting in a stroke, during an IV start. This can be classified as which type of risk?

• A. Patient dissatisfaction
• B. Medical-legal incident
• C. Medication error
• D. Diagnostic procedure

Correct answer: D

Rationale: The correct answer is D, 'Diagnostic procedure.' When a client experiences an air emboli leading to a stroke during an IV start, it falls under the category of a diagnostic procedure risk. This incident occurred during a procedure intended for diagnosis or evaluation. Choices A, B, and C are incorrect. Patient dissatisfaction refers to a client's discontent with care, service, or outcomes; a medical-legal incident involves legal issues related to healthcare practices; and a medication error pertains to mistakes in medication administration.

3. Which of the following is a common characteristic of a high reliability organization (HRO)?

• A. Flexibility
• B. Reluctance to simplify
• C. Preoccupation with failure
• D. Deference to expertise

Correct answer: C

Rationale: A common characteristic of a high reliability organization (HRO) is a preoccupation with failure. HROs focus on identifying and addressing potential failure points to prevent errors and maintain high levels of safety and reliability. This mindset helps them anticipate and mitigate risks proactively, leading to better outcomes and performance. Choices A, B, and D are incorrect. While flexibility, reluctance to simplify, and deference to expertise may be important in various contexts, they are not the primary defining characteristics of a high reliability organization. The core focus of HROs is on continuously monitoring for potential failures and working to prevent them.

4. Which of the following best describes the concept of shared decision-making in healthcare?

• A. The process by which patients make healthcare decisions on their own
• B. A collaborative process that allows patients and providers to make healthcare decisions together
• C. A method for providers to dictate treatment plans to patients
• D. The use of evidence-based guidelines to make healthcare decisions

Correct answer: B

Rationale: The correct answer is B. Shared decision-making in healthcare involves a collaborative process between patients and providers to make healthcare decisions together. This approach considers the patient's preferences, values, and the best available evidence to reach a decision that aligns with the patient's goals. Choice A is incorrect because shared decision-making does not involve patients making decisions on their own. Choice C is incorrect as it describes a paternalistic approach where providers dictate treatment plans to patients without involving them in the decision-making process. Choice D is incorrect as it refers to the use of evidence-based guidelines, which is important but not the sole focus of shared decision-making.

5. What is the primary focus of the Triple Aim in healthcare?

• A. Improving patient experience
• B. Reducing healthcare costs
• C. Improving population health
• D. Ensuring regulatory compliance

Correct answer: A

Rationale: The primary focus of the Triple Aim in healthcare is indeed improving patient experience. While reducing healthcare costs and improving population health are important components of the Triple Aim framework, the primary goal is to enhance the overall experience of patients. Ensuring regulatory compliance, although important in healthcare, is not one of the primary focuses of the Triple Aim.

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