Nursing Elites

1. What is the main focus of health literacy initiatives?

• A. To promote the use of medical jargon
• B. To improve patient communication skills
• C. To ensure that patients understand their health information
• D. To reduce the use of electronic health records

Correct answer: C

Rationale: The main focus of health literacy initiatives is to ensure that patients understand their health information. By improving patient comprehension, individuals can make informed decisions about their health, leading to better health outcomes. Promoting the use of medical jargon would have the opposite effect, making health information less accessible. Improving patient communication skills is important but not the primary focus of health literacy initiatives. Electronic health records are tools for managing health information and not directly related to the main goal of health literacy initiatives.

2. A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses?

• A. Moral suffering
• B. Moral distress
• C. Ethical dilemma
• D. Veracity

Correct answer: B

Rationale: The correct answer is B, moral distress. Moral distress occurs when one knows the ethically correct action to take but feels constrained in their ability to take that action due to institutional, hierarchical, or other constraints. In this scenario, the nurses are experiencing uneasiness and discomfort due to an ethical issue, which aligns with the definition of moral distress. Choice A, moral suffering, is not the most appropriate term in this context as moral distress better describes the situation. Choice C, ethical dilemma, refers to a situation where a person is faced with two equally undesirable alternatives, which does not fully capture the nurses' current experience. Choice D, veracity, is unrelated to the nurses' situation and does not fit the context of the scenario.

3. Which of the following best describes the concept of total quality management (TQM)?

• A. Top-down management
• B. Employee-centered approach
• C. Continuous improvement
• D. Quality control

Correct answer: C

Rationale: The correct answer is C: Continuous improvement. Total quality management (TQM) focuses on continuously improving all aspects of healthcare delivery to enhance patient care, safety, and overall quality. Choice A, 'Top-down management,' does not capture the essence of TQM, which involves involvement at all levels of an organization. Choice B, 'Employee-centered approach,' while important, is not the defining characteristic of TQM. Choice D, 'Quality control,' is a component of TQM but does not fully encompass its comprehensive approach to quality improvement.

4. In a multiple-car accident with multiple trauma clients being sent to an Emergency Department, which type of leadership would be most effective in this situation?

• A. Democratic
• B. Bureaucratic
• C. Laissez-faire
• D. Autocratic

Correct answer: D

Rationale: In a high-stress situation like a multiple-car accident with multiple trauma clients arriving at the Emergency Department, autocratic leadership is most effective. This type of leadership allows for clear direction and quick decision-making, crucial in managing emergencies. Democratic leadership may slow down the decision-making process due to the need for consensus. Bureaucratic leadership focuses on following established rules and procedures, which may not be flexible enough in an emergency. Laissez-faire leadership, characterized by a hands-off approach, is not suitable in urgent situations where immediate action is required.

5. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?

• A. Measure the ankle-brachial index.
• B. Check for changes in skin pigmentation.
• C. Assess for unilateral or bilateral foot drop.
• D. Ask the patient about symptoms of depression.

Correct answer: A

Rationale: The correct answer is A: Measure the ankle-brachial index. This task involves using a Doppler ultrasound device to assess blood flow, which can be safely delegated to UAP. Choices B, C, and D require a higher level of assessment and interpretation that should be performed by licensed nursing staff. Checking for changes in skin pigmentation (B) and assessing for foot drop (C) involve more complex assessments that require nursing judgment. Asking about symptoms of depression (D) involves a psychosocial assessment, which should be performed by licensed personnel qualified to address mental health concerns.

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