Nursing Elites

1. What is the primary function of discipline?

• A. To punish
• B. To evaluate
• C. To teach
• D. To ridicule

Correct answer: C

Rationale: The primary function of discipline is to teach individuals appropriate behavior and help them learn from their mistakes. Discipline is meant to guide individuals towards self-improvement and understanding of rules and expectations. Choices A, B, and D are incorrect because discipline is not primarily about punishment, evaluation, or ridicule. While consequences may be a part of discipline, the main goal is to educate and promote positive behavior.

2. What is the main purpose of a utilization review?

• A. Evaluate patient outcomes
• B. Ensure compliance with regulations
• C. Reduce hospital readmissions
• D. Assess financial impact

Correct answer: A

Rationale: The main purpose of a utilization review is to evaluate patient outcomes and ensure that patients receive appropriate care based on medical necessity and quality standards. While ensuring compliance with regulations, reducing hospital readmissions, and assessing financial impact are important aspects of healthcare management, the primary goal of utilization review is to focus on the quality and effectiveness of patient care.

3. Which of the following are effective strategies to become more resilient? (EXCEPT)

• A. Exercising and avoiding high-fat foods.
• B. Managing time effectively.
• C. Becoming more self-aware.
• D. Deciding that your career is not your highest priority.

Correct answer: D

Rationale: Resilience can be enhanced through various strategies such as exercising, managing time effectively, and becoming more self-aware. Deciding that your career is not your highest priority may not necessarily contribute to building resilience as it does not directly address the personal traits and coping mechanisms associated with resilience. This choice focuses more on prioritization rather than the specific skills and mindset needed to bounce back from challenges. Sherman's study (2004) highlighted the importance of self-awareness in preventing burnout among nurses, emphasizing the value of self-care and personal well-being in maintaining resilience.

4. Which type of HMO contracts with two or more IPAs (Independent Practice Associations)?

• A. Staff model
• B. Point of service model
• C. Network model
• D. Group model

Correct answer: C

Rationale: The correct answer is C: Network model. A network model of HMOs contracts with two or more IPAs. In a network model, the HMO contracts with multiple IPAs to provide healthcare services to its members, offering a wider range of choices and flexibility in selecting healthcare providers. Choices A, B, and D are incorrect because the staff model involves employing physicians and healthcare providers directly, the point of service model allows members to seek care both in-network and out-of-network, and the group model is not specifically associated with contracting IPAs.

5. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

• A. give a bolus of 50% dextrose.
• B. insert a large-bore IV catheter.
• C. initiate oxygen via nasal cannula.
• D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

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