Nursing Elites

1. The type of theory that discusses how motivation works to direct a person's efforts is:

• A. Reinforcement.
• B. Operant.
• C. Conditioning.
• D. Process.

Correct answer: D

Rationale: The correct answer is D, Process. Process theory focuses on how motivation directs an individual's efforts into performance. Reinforcement theory, on the other hand, views motivation as a form of learning. It involves operant conditioning, where behavior is associated with consequences. Conditioning is a broad term that includes both classical and operant conditioning, but it does not specifically address how motivation directs efforts. Therefore, choices A, B, and C are incorrect in the context of discussing how motivation works to direct a person's efforts.

2. Which of the following best describes the concept of value-based healthcare?

• A. Focusing on the volume of services provided
• B. Maximizing hospital revenue
• C. Improving clinical outcomes while controlling costs
• D. Emphasizing patient satisfaction

Correct answer: C

Rationale: The correct answer is C. Value-based healthcare focuses on improving clinical outcomes while controlling costs. It emphasizes quality over quantity, aiming to provide efficient and effective care that enhances patient health outcomes while managing expenses. Choices A and B are incorrect because value-based healthcare is not about focusing on the volume of services provided or maximizing hospital revenue. Choice D, emphasizing patient satisfaction, is also not the primary focus of value-based healthcare, which prioritizes clinical outcomes and cost control.

3. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?

• A. Urine dipstick for glucose
• B. Oral glucose tolerance test
• C. Fasting blood glucose level
• D. Glycosylated hemoglobin level

Correct answer: D

Rationale: The correct answer is D: Glycosylated hemoglobin level. Glycosylated hemoglobin, also known as hemoglobin A1c, provides a long-term indicator of blood glucose control over the past 2-3 months. It is a valuable tool in assessing the effectiveness of diabetes treatment because it reflects average blood sugar levels during this period. Choices A, B, and C are not as effective for evaluating long-term glucose control. Urine dipstick for glucose only provides a snapshot of glucose levels at the time of testing, oral glucose tolerance test evaluates how the body processes glucose after drinking a sugary solution, and fasting blood glucose level gives a point-in-time measurement of glucose levels after fasting, but they do not reflect the overall glucose control over several months.

4. Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)

• A. Notify the nursing supervisor.
• B. Notify security.
• C. Have them check patients to verify safety.
• D. Ask construction workers to be responsible.

Correct answer: D

Rationale: When construction is ongoing in a healthcare setting, it is essential to address safety concerns promptly. While it is crucial to notify the nursing supervisor and security to manage potential risks, having staff check patients for safety is also a valid precautionary measure. However, asking construction workers to be responsible is not a proper action to address the safety concerns posed by the equipment. Construction workers are professionals responsible for their tasks; it is the healthcare facility's responsibility to ensure patient and staff safety in such situations.

5. 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.

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