Nursing Elites

1. Which of the following is an essential element of a quality improvement (QI) program?

• A. Blame and punishment
• B. Employee satisfaction
• C. Continual monitoring
• D. Strict adherence to policies

Correct answer: C

Rationale: The essential element of a quality improvement (QI) program is continual monitoring. Continual monitoring allows for the ongoing assessment of processes, identification of areas for improvement, and tracking of progress. Option A, 'Blame and punishment,' is incorrect as QI programs focus on systemic issues rather than individual blame. Option B, 'Employee satisfaction,' while important for organizational culture, is not an essential element of QI programs. Option D, 'Strict adherence to policies,' is valuable but not the core essential element, which is continual monitoring to drive improvement.

2. The belief that effort will lead to a specific performance level in an individual is known as:

• A. Rewards.
• B. Expectancy.
• C. Valence.
• D. Instrumentality.

Correct answer: B

Rationale: The correct answer is B: Expectancy. Expectancy refers to the perceived probability that effort will lead to a specific performance level. This aligns with the concept of expectancy theory in psychology, which emphasizes the importance of individuals' beliefs regarding the link between effort and outcomes. Choices A, C, and D are incorrect. Rewards (choice A) typically refer to incentives given after achieving a goal, valence (choice C) is the value a person places on a particular outcome, and instrumentality (choice D) is the belief that a particular outcome is contingent on achieving a specific level of performance.

3. A nurse is considering employment at a long-term care facility that has a functional nursing delivery system. Knowing this, the nurse could expect that:

• A. Each RN would coordinate care for a group of clients.
• B. One RN would pass meds for all clients on a unit.
• C. Each RN would deliver total care to an assigned group of clients.
• D. One RN, one LPN, and one unlicensed assistive personnel would share responsibility for a group of clients.

Correct answer: B

Rationale: In a functional nursing delivery system, tasks are divided among the staff based on their roles. One of these roles is medication administration, where one RN may pass medications for all clients on a unit. Option A is incorrect because coordinating care for a group of clients is more aligned with team nursing. Option C is incorrect as it describes total care nursing, not functional nursing. Option D is incorrect as it reflects team nursing with a mix of different roles sharing responsibility.

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. Which of the following best describes the concept of value-based healthcare?

• A. Focusing on the volume of services provided
• B. Maximizing hospital revenue
• C. Improving clinical outcomes while controlling costs
• D. Emphasizing patient satisfaction

Correct answer: C

Rationale: The correct answer is C. Value-based healthcare focuses on improving clinical outcomes while controlling costs. It emphasizes quality over quantity, aiming to provide efficient and effective care that enhances patient health outcomes while managing expenses. Choices A and B are incorrect because value-based healthcare is not about focusing on the volume of services provided or maximizing hospital revenue. Choice D, emphasizing patient satisfaction, is also not the primary focus of value-based healthcare, which prioritizes clinical outcomes and cost control.

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