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. Which of the following is a challenge the profession of nursing faced?

• A. Nursing contributing to the stigma of AIDS in the 1980s out of fear.
• B. Nursing practice flourishing in field hospitals during the Korean War with abundant supplies and equipment.
• C. Many nurses feeling frustrated with the lack of independent functioning after the Vietnam War.
• D. A decline in the number of hospice nurses due to ethical dilemmas.

Correct answer: C

Rationale: The correct answer is C. After the Vietnam War, many nurses felt frustrated with the lack of independent functioning when they returned home. This challenge was faced by the profession of nursing as nurses who functioned independently in mobile hospital units during the war found themselves restricted in their practice upon returning. Choices A, B, and D are incorrect because they do not address the specific challenge of lack of independent functioning faced by nurses after the Vietnam War.

3. In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?

• A. First
• B. Second
• C. Third
• D. Fourth

Correct answer: A

Rationale: The correct answer is A: First. In the grievance process, the initial step involves the nurse talking to the nurse manager to address the issue informally. Subsequently, step two entails filing a written appeal to the director of nursing or designee. Step three involves a formal meeting with the employee, agent, grievance chairperson, nursing administrator, and director of human resources. The final step, step four, is arbitration, which is initiated when no mutually acceptable solutions can be reached by the involved parties. Therefore, the nurse talking to the nurse manager about the disagreement is the first step in the grievance process.

4. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?

• A. Teach the patient about administering regular insulin.
• B. Schedule the patient for a fasting blood glucose level.
• C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
• D. Provide teaching about an increased risk for fetal problems with gestational diabetes.

Correct answer: B

Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.

5. The changes brought forth by the state boards of nursing are an example of which type of change agent?

• A. Resistance
• B. Empirical–rational
• C. Normative–reeducative
• D. Power–coercive

Correct answer: D

Rationale: The changes implemented by state boards of nursing typically fall under the category of Power–coercive change agents. State boards of nursing have the authority to enforce changes through regulations and policies, making use of their legitimate power. Resistance (choice A) is not the correct answer as it refers to opposition to change rather than the entity driving change. Empirical–rational (choice B) focuses on convincing individuals through empirical evidence and rational arguments, which is not reflective of the state boards' authority. Normative–reeducative (choice C) involves persuading individuals to change based on shared values and beliefs, which is not the primary approach of state boards of nursing.

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