Nursing Elites

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

• A. Coordinate patient care
• B. Administer treatments
• C. Provide health education
• D. Conduct research

Correct answer: A

Rationale: The primary role of a nurse in a patient-centered medical home (PCMH) is to coordinate patient care. Nurses in PCMH settings focus on ensuring continuity of care, managing transitions between different healthcare providers, and facilitating communication among the healthcare team and the patient. Administering treatments, providing health education, and conducting research are important aspects of nursing practice but are not the primary role of a nurse in a patient-centered medical home.

2. A nurse is considering employment at a long-term care facility that has a functional nursing delivery system. Knowing this, the nurse could expect that:

• A. Each RN would coordinate care for a group of clients.
• B. One RN would pass meds for all clients on a unit.
• C. Each RN would deliver total care to an assigned group of clients.
• D. One RN, one LPN, and one unlicensed assistive personnel would share responsibility for a group of clients.

Correct answer: B

Rationale: In a functional nursing delivery system, tasks are divided among the staff based on their roles. One of these roles is medication administration, where one RN may pass medications for all clients on a unit. Option A is incorrect because coordinating care for a group of clients is more aligned with team nursing. Option C is incorrect as it describes total care nursing, not functional nursing. Option D is incorrect as it reflects team nursing with a mix of different roles sharing responsibility.

3. A 27-year-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium level of 3.1 mEq/L. Which action prescribed by the healthcare provider should the nurse take first?

• A. Place the patient on a cardiac monitor
• B. Administer IV potassium supplements
• C. Obtain urine glucose and ketone levels
• D. Start an insulin infusion at 0.1 units/kg/hr

Correct answer: A

Rationale: In a patient with diabetic ketoacidosis (DKA), the initial priority is to assess for any cardiac arrhythmias due to electrolyte imbalances. Since the patient has a low serum potassium level of 3.1 mEq/L, placing the patient on a cardiac monitor is crucial to monitor for any potential cardiac complications. Administering IV potassium supplements (Choice B) may be needed, but it is not the first action to take. Obtaining urine glucose and ketone levels (Choice C) and starting an insulin infusion (Choice D) are important interventions in managing DKA, but ensuring patient safety by monitoring for arrhythmias takes precedence.

4. Which of the following is an example of a conflict of interest in nursing?

• A. A nurse accepting gifts from a patient
• B. A nurse working for two competing healthcare organizations
• C. A nurse disclosing patient information without consent
• D. A nurse delegating tasks improperly

Correct answer: B

Rationale: The correct answer is B. A nurse working for two competing healthcare organizations represents a conflict of interest as it may affect impartiality. Choice A is incorrect as accepting gifts from a patient may be a violation of ethical standards, but it is not a conflict of interest. Choice C is incorrect as disclosing patient information without consent is a breach of confidentiality, not a conflict of interest. Choice D is incorrect as delegating tasks improperly relates to professional competence, not a conflict of interest.

5. 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.

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