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 client experiences an air emboli, resulting in a stroke, during an IV start. This can be classified as which type of risk?

• A. Patient dissatisfaction
• B. Medical-legal incident
• C. Medication error
• D. Diagnostic procedure

Correct answer: D

Rationale: The correct answer is D, 'Diagnostic procedure.' When a client experiences an air emboli leading to a stroke during an IV start, it falls under the category of a diagnostic procedure risk. This incident occurred during a procedure intended for diagnosis or evaluation. Choices A, B, and C are incorrect. Patient dissatisfaction refers to a client's discontent with care, service, or outcomes; a medical-legal incident involves legal issues related to healthcare practices; and a medication error pertains to mistakes in medication administration.

3. Which of the following is a challenge the profession of nursing faced?

• A. Nursing contributing to the stigma of AIDS in the 1980s out of fear.
• B. Nursing practice flourishing in field hospitals during the Korean War with abundant supplies and equipment.
• C. Many nurses feeling frustrated with the lack of independent functioning after the Vietnam War.
• D. A decline in the number of hospice nurses due to ethical dilemmas.

Correct answer: C

Rationale: The correct answer is C. After the Vietnam War, many nurses felt frustrated with the lack of independent functioning when they returned home. This challenge was faced by the profession of nursing as nurses who functioned independently in mobile hospital units during the war found themselves restricted in their practice upon returning. Choices A, B, and D are incorrect because they do not address the specific challenge of lack of independent functioning faced by nurses after the Vietnam War.

4. After change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

5. Which of the following is a primary responsibility of a nurse case manager?

• A. Direct patient care
• B. Financial planning
• C. Conduct health education
• D. Coordinate patient transitions

Correct answer: D

Rationale: A primary responsibility of a nurse case manager is to coordinate patient transitions. This involves ensuring smooth transitions between healthcare settings, coordinating care plans, and ensuring continuity of care for patients. While direct patient care, financial planning, and health education are important aspects of healthcare, they are not primary responsibilities of a nurse case manager. Nurse case managers focus on managing and coordinating the overall care and services for patients.

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