Nursing Elites

1. When should a critical pathway be revised?

• A. When variances show a new trend.
• B. When the variances show a new trend.
• C. When a member of the team retires.
• D. When the client leaves the hospital.

Correct answer: B

Rationale: A critical pathway should be revised when variances in the patient's progress indicate a new trend or deviation from the expected course of treatment. This allows healthcare providers to adjust the pathway to ensure optimal patient care and outcomes. Changes in the critical pathway are not typically driven by its length or external factors like team member retirements or client discharges. Therefore, the correct answer is B. Choice A is a better phrasing of the correct answer, emphasizing the importance of variances showing a new trend. Choices C and D are irrelevant to the patient's progress and treatment plan, making them incorrect.

2. A client with frequent tonic-clonic seizures is being admitted. What action should the nurse add to the client's plan of care?

• A. Ensure blankets are placed on all four sides of the bed.
• B. Refrain from using restraints during seizure activity.
• C. Position the client laterally during seizure activity.
• D. Have a tongue depressor available at the client's bedside.

Correct answer: D

Rationale: The correct action the nurse should add to the client's plan of care is to have a tongue depressor available at the client's bedside. This is important during a seizure to prevent the client from biting their tongue. Placing the client laterally helps maintain a clear airway and prevents aspiration, making choice C a good practice during seizure activity. Using restraints during a seizure can cause injuries and should be avoided, making choice B incorrect. Wrapping blankets around all four sides of the bed is unnecessary for seizure management and does not contribute to the client's safety during a seizure, making choice A incorrect.

3. What is the primary goal of the Affordable Care Act (ACA)?

• A. To reduce healthcare costs
• B. To expand access to healthcare
• C. To improve healthcare quality
• D. To increase healthcare funding

Correct answer: B

Rationale: The primary goal of the Affordable Care Act (ACA) is to expand access to healthcare. While reducing healthcare costs and improving healthcare quality are important aspects, the ACA's main focus was on increasing the number of Americans with health insurance coverage and enhancing the availability and affordability of healthcare services. Increasing healthcare funding is not the primary goal of the ACA, as its main aim was to make healthcare more accessible and affordable for a larger portion of the population.

4. While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.

• A. Parallel
• B. Functional
• C. Service-integrated
• D. Matrix

Correct answer: B

Rationale: The correct answer is 'Functional.' In a functional structure, organizations group employees into departments based on specialty, where similar tasks are performed by the same group. In this scenario, the hospital organizing its departments by specialty such as nursing, dietary, and pharmacy aligns with the characteristics of a functional structure. Choice A, 'Parallel,' does not fit the scenario described; parallel structures involve separate, independent units operating in parallel with little interaction. Choice C, 'Service-integrated,' does not align with the scenario either as it involves integrating services across departments. Choice D, 'Matrix,' is not the correct answer as it involves a complex organizational structure where employees report to multiple managers simultaneously, which is not the case in the scenario provided.

5. One way to determine staffing needs is to classify clients according to nursing care required. Another name for this is a(n) __________.

• A. self-scheduling
• B. supplementing staff system
• C. patient classification system (PCS)
• D. acuity system

Correct answer: D

Rationale: The correct answer is D: acuity system. An acuity system involves classifying clients based on the nursing care they require to determine staffing needs accurately. Choice A, self-scheduling, is not related to classifying clients based on care needs. Choice B, supplementing staff system, does not specifically refer to the classification of clients. Choice C, patient classification system (PCS), is close but not as commonly used as 'acuity system' in healthcare settings to determine staffing needs.

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