Nursing Elites

1. What is the primary purpose of a patient-centered medical home (PCMH)?

• A. To coordinate all aspects of patient care
• B. To reduce healthcare costs
• C. To implement the latest clinical guidelines
• D. To provide financial incentives for providers

Correct answer: A

Rationale: The correct answer is A: 'To coordinate all aspects of patient care.' A patient-centered medical home (PCMH) aims to provide comprehensive and continuous care by coordinating various aspects of a patient's healthcare needs. While reducing healthcare costs and implementing clinical guidelines are important goals in healthcare, the primary focus of a PCMH is on enhancing patient care coordination to improve outcomes and patient satisfaction. Providing financial incentives for providers is not the primary purpose of a PCMH, although it can be a component of some models to encourage quality care delivery.

2. The ANA recommends that nursing in the health care organization change its focus. This requires a shift from a technical model to which of the following?

• A. Professional
• B. Industrial
• C. Random
• D. Organized

Correct answer: A

Rationale: The correct answer is A: Professional. The American Nurses Association (ANA) recommends shifting the focus in healthcare organizations from a technical model to a professional model. This change emphasizes the level of nurse competence required to provide quality care. Choice B, Industrial, is incorrect as it does not align with the focus on professionalism in nursing. Choice C, Random, is unrelated to the context of the question. Choice D, Organized, while a positive attribute, is not the specific focus recommended by the ANA for nursing in healthcare organizations.

3. Which of the following statements is true regarding nursing ethics?

• A. Nursing ethics focus on the organizational level at the workplace.
• B. Nursing ethics focus on the duties and rules of behavior for professional nurses.
• C. Nursing ethics focus on the moral character of nurses.
• D. Nursing ethics focus on the experiences and needs of nurses.

Correct answer: D

Rationale: Nursing ethics not only focus on the experiences and needs of nurses, but also on the nurses� perceptions of these experiences.

4. A nurse is discussing the responsibility of caring for clients with clostridium difficile infection. Which of the following information should the nurse include in the teaching?

• A. Have family members wear a gown and gloves when visiting.
• B. Clean contaminated surfaces in the client's room with a bleach solution.
• C. Use alcohol-based hand sanitizer when leaving the client's room.
• D. Assign the client to a room with a private bathroom.

Correct answer: A

Rationale: When caring for clients with clostridium difficile infection, it is important to prevent the spread of the bacteria. Having family members wear a gown and gloves when visiting helps reduce the risk of transmission. Cleaning contaminated surfaces with a bleach solution, not phenol, is recommended to effectively kill the C. difficile spores. Using alcohol-based hand sanitizer is not sufficient, as it may not be effective against C. difficile spores. Assigning the client to a room with a private bathroom is more beneficial than a negative airflow system, as it helps prevent the spread of bacteria to other clients.

5. During a physical assessment of adult clients, which of the following techniques should the nurse use?

• A. Use the Face, Legs, Activity, Cry, and Consolability (FLACC) pain rating scale for a client experiencing pain.
• B. Palpate the client's abdomen before auscultating bowel sounds.
• C. Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.
• D. Obtain an apical heart rate by auscultating at the third intercostal space to the left of the sternum.

Correct answer: B

Rationale: When performing a physical assessment, it is essential to palpate the client's abdomen before auscultating bowel sounds. This sequence helps prevent altering bowel sound results due to the pressure applied during palpation. Choice A is incorrect because the FLACC pain rating scale is typically used for nonverbal or pediatric clients, not adults. Choice C is incorrect because the bladder of the blood pressure cuff should surround about 80% of the client's arm circumference, not the bladder of the cuff itself. Choice D is incorrect because to obtain an apical heart rate, auscultation should be done at the fifth intercostal space at the midclavicular line, not at the third intercostal space to the left of the sternum.

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