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1. Which of the following scenarios would be an example of shared governance on a nursing unit?
- A. Staff nurses delegate activities to CNAs.
- B. Procedure manuals are written by a committee of nurse managers.
- C. Staff nurses and CNAs make their own schedules.
- D. A unit manager seeks advice from her supervisor.
Correct answer: C
Rationale: The correct answer is C. Shared governance in a nursing unit involves staff nurses and CNAs having autonomy and decision-making power in aspects like scheduling, which is reflected in them making their own schedules. This scenario aligns with the philosophy of shared governance where nursing practice is best determined by nurses. Choices A, B, and D do not exemplify shared governance as they involve hierarchical delegation, managerial decision-making, and seeking advice from superiors rather than autonomous decision-making by frontline staff.
2. Integrated health care systems function in a variety of models. Which of the following is a common characteristic of all systems?
- A. Deliver selective care only
- B. Deliver a whole continuum of care
- C. Treat patients only in the hospital
- D. Provide care only in the primary care setting
Correct answer: B
Rationale: Integrated health care systems are designed to provide a whole continuum of care, which includes preventive, primary, specialty, hospital, and long-term care services. This integration ensures that patients receive comprehensive and coordinated care across different healthcare settings. Choice A is incorrect because integrated systems aim to provide a wide range of services, not selective care only. Choice C is incorrect as integrated systems extend care beyond hospital settings. Choice D is incorrect as these systems offer care across various settings, not limited to primary care only.
3. Monitoring the number of times a medication is given utilizing the 'five rights' is an example of which phase of the Six Sigma program?
- A. Measure
- B. Management
- C. Quantitative
- D. Goal
Correct answer: A
Rationale: In the Six Sigma program, the 'Measure' phase focuses on monitoring and measuring processes to ensure they meet the desired standards. This includes tracking the number of times a medication is given correctly using the 'five rights' principle. Therefore, the correct answer is A. Choice B, 'Management,' does not specifically relate to monitoring processes or data collection, so it is not the correct answer. Choice C, 'Quantitative,' refers to the use of numerical data in decision-making, which is a broader concept and not specific to monitoring processes within the Six Sigma framework. Choice D, 'Goal,' is too general and does not capture the specific phase of Six Sigma that involves monitoring and measuring processes.
4. An RN enters a patient�s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?
- A. The RN tells the client he is not allowed to leave until the physician has released him.
- B. The RN asks the client why he wishes to leave.
- C. The RN asks the client to explain what he understands about his medical diagnosis.
- D. The RN asks the client to sign an against medical advice discharge form.
Correct answer: A
Rationale: Verbal or physical detainment of a client who desires to leave the institution is false imprisonment.
5. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
- A. Urine dipstick for glucose
- B. Oral glucose tolerance test
- C. Fasting blood glucose level
- D. Glycosylated hemoglobin level
Correct answer: D
Rationale: The correct answer is D: Glycosylated hemoglobin level. Glycosylated hemoglobin, also known as hemoglobin A1c, provides a long-term indicator of blood glucose control over the past 2-3 months. It is a valuable tool in assessing the effectiveness of diabetes treatment because it reflects average blood sugar levels during this period. Choices A, B, and C are not as effective for evaluating long-term glucose control. Urine dipstick for glucose only provides a snapshot of glucose levels at the time of testing, oral glucose tolerance test evaluates how the body processes glucose after drinking a sugary solution, and fasting blood glucose level gives a point-in-time measurement of glucose levels after fasting, but they do not reflect the overall glucose control over several months.
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