Nursing Elites

1. What is the primary goal of discharge planning?

• A. Reducing readmission rates
• B. Improving patient outcomes
• C. Ensuring continuity of care
• D. Ensuring medication adherence

Correct answer: C

Rationale: The primary goal of discharge planning is to ensure continuity of care for patients transitioning from one level of care to another. While reducing readmission rates and improving patient outcomes are important aspects of discharge planning, the main focus is on coordinating care to prevent gaps and ensure a seamless transition for the patient. Ensuring medication adherence is also crucial but falls under the broader goal of continuity of care.

2. A nurse manager wants to implement a new policy on the unit. What is the first step in the change process according to Lewin's Change Theory?

• A. Unfreeze the system
• B. Move the system to a new level
• C. Refreeze the system
• D. Evaluate the system

Correct answer: A

Rationale: The correct answer is A: 'Unfreeze the system.' According to Lewin's Change Theory, unfreezing the system is the initial step in the change process. This step involves preparing the organization for change by creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Choice B, 'Move the system to a new level,' is incorrect as it does not align with the first step of unfreezing. Choice C, 'Refreeze the system,' is incorrect as it pertains to the final stage of solidifying the change, not the first step. Choice D, 'Evaluate the system,' is incorrect as evaluation typically occurs after the change has been implemented, not at the beginning of the change process.

3. Why is increasing the use of advanced practice nurses encouraged?

• A. A 2010 Institute of Medicine report recommended nurses practice to the full extent of their education.
• B. Advanced practice nurses act as an extension of physicians.
• C. The National League for Nursing advocates for the master of science in nursing (MSN) as the terminal degree for nurse practitioners.
• D. Advanced practice nurses lack the skills to diagnose.

Correct answer: A

Rationale: The correct answer is A because the 2010 Institute of Medicine report recommended that nurses practice to the full extent of their education, which includes utilizing advanced practice nurses. This supports the efficient delivery of healthcare services by leveraging the expertise and skills of advanced practice nurses. Choice B is incorrect as it describes the role of advanced practice nurses rather than providing a reason for increasing their use. Choice C is unrelated to the encouragement of increasing the use of advanced practice nurses as it focuses on the terminal degree for nurse practitioners. Choice D is incorrect as advanced practice nurses do possess the skills necessary to diagnose and provide advanced care, so the statement that they lack diagnostic skills is inaccurate.

4. Horizontal violence may be observed among staff interactions and causes stress among staff. To minimize stress associated with such interactions, nurses can: (Select all that apply.)

• A. Encourage venting as a way to express feelings.
• B. Take control of the situation by being assertive.
• C. Ignore staff who are volatile.
• D. Avoid interactions with angry staff.

Correct answer: B

Rationale: To minimize stress associated with horizontal violence among staff interactions, nurses should take control of the situation by being assertive. Being assertive allows nurses to address the issues causing stress in a constructive and professional manner. Encouraging venting without addressing the underlying problems may not resolve the situation effectively. Ignoring staff who are volatile can escalate the issue further, and avoiding interactions with angry staff does not address the root cause of the problem. Therefore, being assertive and addressing the situation directly is the most effective approach to minimize stress and promote a healthy work environment.

5. Which of the following best describes the role of a nurse navigator?

• A. Provide direct patient care
• B. Coordinate complex care
• C. Assist with administrative tasks
• D. Manage clinical trials

Correct answer: B

Rationale: A nurse navigator's primary role is to coordinate complex care for patients, guiding them through the healthcare system. Choice A is incorrect because nurse navigators do not provide direct patient care like nurses in clinical settings. Choice C is incorrect as nurse navigators focus on patient care coordination rather than administrative tasks. Choice D is incorrect as managing clinical trials is typically not within the scope of a nurse navigator's responsibilities.

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