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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. Which of the following is the preferable alternative to firing an employee?
- A. Voluntary resignation
- B. Training
- C. Confrontation
- D. Coaching
Correct answer: A
Rationale: The preferable alternative to firing an employee is voluntary resignation. When an employee voluntarily resigns, it allows them to leave on their terms, maintaining their dignity and possibly avoiding negative consequences associated with being fired. Training, confrontation, and coaching are not alternatives to firing but rather methods that can be used to address performance or behavior issues before resorting to termination.
3. Verbal interventions with an agitated patient may be calming. These interventions include:
- A. Holding and reassuring the patient
- B. Encouraging other staff to distract the patient
- C. Remaining calm and keeping an arm's distance
- D. Standing close to the patient while talking
Correct answer: C
Rationale: The correct answer is C: Remaining calm and keeping an arm's distance. Agitated individuals benefit from minimal verbal and physical stimulation. They respond to their environment based on how nurses interact with them. If an individual feels threatened or cornered, the response will generally be self-protective and reactive. Standing close to the patient (choice D) can be perceived as invasive and may escalate the situation. Holding and reassuring the patient (choice A) may not be effective if the patient perceives it as intrusive. Encouraging other staff to distract the patient (choice B) may introduce unnecessary stimulation. Therefore, the recommended approach is to remain calm and keep a safe distance to provide a non-threatening environment for the agitated patient.
4. If a staff member does not respond to discipline, the manager must ______ employment.
- A. Terminate
- B. Confront
- C. Describe the staff nurse's behavior that violated the policy
- D. Determine the employee's awareness of the policy
Correct answer: A
Rationale: When an employee does not respond to disciplinary measures, termination may be necessary. This is a last resort for managers when other strategies to improve performance have failed. Terminating an employee means ending their employment with the organization. Choices B, C, and D are incorrect as the question specifically asks what action the manager must take when an employee does not respond to discipline. Confronting the employee, describing the behavior, or determining awareness of the policy are steps that may precede termination but are not the final action to be taken.
5. What is the term for working on a schedule within the unit, involving only those who are working within that unit?
- A. Flexible staffing
- B. Self-staffing
- C. Internal pools
- D. Management scheduling
Correct answer: B
Rationale: The correct answer is B, self-staffing. Self-staffing is the model where staff entirely manage staffing and scheduling themselves, without external involvement. Choices A, C, and D are incorrect. Flexible staffing refers to adjusting staffing levels based on demand. Internal pools involve a group of staff who can be drawn upon for scheduling needs. Management scheduling typically involves supervisors or managers creating and managing schedules for the unit.
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