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. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?

• A. Teach the patient about administering regular insulin.
• B. Schedule the patient for a fasting blood glucose level.
• C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
• D. Provide teaching about an increased risk for fetal problems with gestational diabetes.

Correct answer: B

Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.

3. Which of the following theories explains that organizations are made up of intertwined links and diversified choices that generate unanticipated consequences?

• A. Contingency theory
• B. Closed system theory
• C. Open system theory
• D. Chaos theory

Correct answer: D

Rationale: The chaos theory explains that organizations are made up of intertwined links and diversified choices that generate unanticipated consequences. Choice A, Contingency theory, focuses on how organizations adapt to their environment. Choice B, Closed system theory, suggests that organizations are self-contained and do not interact with their environment. Choice C, Open system theory, emphasizes that organizations interact with their environment but does not specifically address intertwined links and diversified choices generating unanticipated consequences.

4. Which of the following is an example of an outcome measure in healthcare?

• A. Patient satisfaction scores
• B. Length of hospital stay
• C. Healthcare provider performance reviews
• D. Number of diagnostic tests ordered

Correct answer: A

Rationale: Patient satisfaction scores are considered an outcome measure in healthcare because they reflect the patient's experience and perception of the care received. Patient satisfaction scores focus on the quality of care provided and the patient's overall satisfaction with their healthcare experience. Choices B, C, and D are not examples of outcome measures. The length of hospital stay is a process measure, healthcare provider performance reviews are a provider-specific evaluation, and the number of diagnostic tests ordered is more related to resource utilization rather than a direct patient outcome.

5. A nurse recognizes which of the following as a primary goal of nursing?

• A. Assist patients to achieve a peaceful death.
• B. Improve personal knowledge and skills to enhance patient outcomes.
• C. Advocate for quality of life rather than quantity of life.
• D. Work to control costs to enhance patients' quality of life.

Correct answer: A

Rationale: The primary goal of nursing is to promote health, prevent illness, alleviate suffering, and care for the sick. Assisting patients to achieve a peaceful death is an essential aspect of nursing care, ensuring dignity and comfort in the end-of-life phase. While improving personal knowledge and advocating for quality of life are important aspects of nursing, the primary goal remains the well-being and comfort of patients, even in death. Working to control costs, while a consideration in healthcare, is not the primary goal of nursing, which is centered on patient care and well-being.

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