Nursing Elites

1. Which of the following best describes the concept of shared decision-making in healthcare?

• A. The process by which patients make healthcare decisions on their own
• B. A collaborative process that allows patients and providers to make healthcare decisions together
• C. A method for providers to dictate treatment plans to patients
• D. The use of evidence-based guidelines to make healthcare decisions

Correct answer: B

Rationale: The correct answer is B. Shared decision-making in healthcare involves a collaborative process between patients and providers to make healthcare decisions together. This approach considers the patient's preferences, values, and the best available evidence to reach a decision that aligns with the patient's goals. Choice A is incorrect because shared decision-making does not involve patients making decisions on their own. Choice C is incorrect as it describes a paternalistic approach where providers dictate treatment plans to patients without involving them in the decision-making process. Choice D is incorrect as it refers to the use of evidence-based guidelines, which is important but not the sole focus of shared decision-making.

2. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?

• A. Hemoglobin A1C level is 7.9%.
• B. Last eye exam was 18 months ago.
• C. Glomerular filtration rate is decreased.
• D. Patient has questions about the prescribed diet.

Correct answer: C

Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.

3. Which of the following are essential components of strategic planning? (Select all that apply.)

• A. Values
• B. Vision & Mission statements
• C. Reengineering
• D. A & B

Correct answer: D

Rationale: Values and vision and mission statements are indeed essential components of strategic planning. Values help define the organization's core beliefs and principles, guiding its decisions and actions. Vision and mission statements articulate the organization's goals, purpose, and direction, serving as a roadmap for strategic planning and decision-making. Reengineering is not a core component of strategic planning; it involves the redesign of processes to improve performance, efficiency, and quality. Therefore, option C is incorrect. The correct answer is D because both values and vision and mission statements play crucial roles in shaping an organization's strategic planning process.

4. What is the focus of a continuous quality improvement program?

• A. Family
• B. Client
• C. Nurse
• D. Physician

Correct answer: B

Rationale: The correct answer is B: Client. Continuous quality improvement programs are primarily focused on improving services and outcomes for clients or patients. While families, nurses, and physicians are essential in healthcare, in the context of quality improvement, the main focus is on enhancing the experience and results for the clients receiving care. Choices A, C, and D are incorrect because they do not align with the primary goal of a continuous quality improvement program, which is to enhance client satisfaction, safety, and outcomes.

5. What is the primary goal of a nursing informatics specialist?

• A. Manage patient care
• B. Implement new technology
• C. Improve healthcare delivery
• D. Support clinical decisions

Correct answer: C

Rationale: The primary goal of a nursing informatics specialist is to improve healthcare delivery. While managing patient care, implementing new technology, and supporting clinical decisions are important aspects of their role, the overarching objective is to enhance healthcare delivery by leveraging technology to improve patient outcomes, streamline processes, and optimize care. Therefore, the correct answer is to improve healthcare delivery.

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