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. A nurse is evaluating teaching for a client who has heart failure. Which of the following statements by the client indicates an understanding of the teaching?

• A. I am limiting my sodium intake to 2 grams daily.
• B. I have been weighing myself every other morning.
• C. I am trying to decrease my intake of foods with potassium.
• D. I am eating fewer potato chips and more fruit for snacks.

Correct answer: A

Rationale: The correct answer is A. Limiting sodium intake is crucial for clients with heart failure to manage their condition effectively. Excessive sodium can lead to fluid retention and worsen heart failure symptoms. Weighing oneself is important for monitoring fluid retention but does not directly show an understanding of dietary restrictions. Decreasing potassium intake is not typically recommended for heart failure clients unless specifically advised by a healthcare provider. While choosing healthier snacks is beneficial, the focus on sodium intake is more critical for heart failure management.

3. 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.

4. Which theory views motivation as learning?

• A. Reinforcement
• B. Process
• C. Operant
• D. Conditioning

Correct answer: A

Rationale: The correct answer is A, Reinforcement. Reinforcement theory views motivation as learning through the association of behaviors with consequences. Choice B, Process, is too vague and does not specifically relate motivation to learning. Choice C, Operant, is a type of conditioning that focuses on voluntary behavior and its consequences, not motivation as learning. Choice D, Conditioning, is a general term that does not directly connect motivation with learning.

5. Many patient classification systems have some type of shortcoming. Among these are:

• A. The client's condition changes before the next shift.
• B. The staffing needs are predicted on a short-term basis.
• C. The potential admissions cannot be accounted for.
• D. The staffing mix changes because of illness.

Correct answer: C

Rationale: Patient classification systems have limitations in accounting for changes in a client's condition, unexpected influx of new admissions, and changes in staffing due to illness. These systems often focus on short-term staffing needs rather than utilizing demand management, which considers client outcomes to predict staffing needs over a longer period. Not being able to account for potential admissions can lead to challenges in effectively managing staff allocation and resources. Choices A, B, and D are incorrect because they do not address the specific limitation of patient classification systems related to accounting for potential admissions.

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