Nursing Elites

1. Which of the following is a key component of patient-centered care?

• A. Provider-centered decision making
• B. Timely discharge
• C. Respect for patient preferences
• D. Focusing on clinical outcomes

Correct answer: C

Rationale: The correct answer is C: Respect for patient preferences. Patient-centered care focuses on involving patients in their care decisions and respecting their preferences. Choice A, provider-centered decision making, goes against the concept of patient-centered care as it prioritizes the provider over the patient. Timely discharge, choice B, is important but not a defining component of patient-centered care. Focusing on clinical outcomes, choice D, is essential in healthcare but does not solely represent patient-centered care, which is more about personalized care and involving patients in decision-making.

2. Selye's stress theory explains that a person stressed for long periods of time will:

• A. Face exhaustion and be more susceptible to illnesses.
• B. Become fatigued and become stronger.
• C. Become more assertive.
• D. Safety needs.

Correct answer: A

Rationale: Selye's stress theory posits that individuals experiencing prolonged stress are likely to face exhaustion and become more susceptible to illnesses. This is because the body's response to chronic stress can lead to physical and psychological depletion, increasing the risk of health problems. Choice B is incorrect as becoming stronger is not a typical outcome of prolonged stress according to Selye's theory. Choice C, becoming more assertive, is not directly related to the physical implications of chronic stress. Choice D, safety needs, is unrelated to Selye's stress theory and does not reflect the expected outcomes of prolonged stress.

3. The staff on a medical-surgical unit is in conflict with the occupational therapy department. What type of communication will be used to discuss the problems?

• A. Downward communication
• B. Lateral communication
• C. Distorted communication
• D. Upward communication

Correct answer: B

Rationale: The correct answer is B: Lateral communication. Lateral communication occurs between individuals or departments of the same hierarchical level, making it suitable for addressing conflicts between the staff on a medical-surgical unit and the occupational therapy department. Upward communication involves communication from staff to management or from lower management to middle or upper management. Downward communication is typically directive communication from an authority figure or manager to staff. Distorted communication is not a recognized type of communication and does not apply to this scenario.

4. What is the primary purpose of a patient-centered medical home (PCMH)?

• A. To coordinate all aspects of patient care
• B. To reduce healthcare costs
• C. To implement the latest clinical guidelines
• D. To provide financial incentives for providers

Correct answer: A

Rationale: The correct answer is A: 'To coordinate all aspects of patient care.' A patient-centered medical home (PCMH) aims to provide comprehensive and continuous care by coordinating various aspects of a patient's healthcare needs. While reducing healthcare costs and implementing clinical guidelines are important goals in healthcare, the primary focus of a PCMH is on enhancing patient care coordination to improve outcomes and patient satisfaction. Providing financial incentives for providers is not the primary purpose of a PCMH, although it can be a component of some models to encourage quality care delivery.

5. Your nurse manager talks with you once per week to determine how you are adjusting to your role as a new nurse. She asks if you feel that you are able to provide good care to your patients, whether you are becoming familiar with the electronic health record, and whether your preceptor is encouraging your independence. This manager is demonstrating:

• A. An intrusive style.
• B. An effort to understand if you are coping with the demands.
• C. An attempt to intimidate.
• D. An authoritarian style.

Correct answer: B

Rationale: The correct answer is B. The nurse manager is showing an effort to understand if you are coping with the demands of your new role as a nurse. This approach demonstrates empathy and concern for your well-being and professional development. Choices A, C, and D are incorrect because there is no indication of intrusion, intimidation, or authoritarian behavior in the manager's actions. Instead, the manager is engaging in supportive and constructive communication to help you adjust and grow in your new position.

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