Nursing Elites

1. Which of the following theories best describes current health care delivery systems?

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

Correct answer: D

Rationale: The contingency theory best describes the current health care delivery systems. Contingency theory emphasizes that there is no one best way to organize or manage, and the effectiveness of an organization is contingent upon internal and external factors. In healthcare, the delivery systems must often adapt and be flexible in response to various factors like patient needs, technological advancements, and regulatory changes. Open system theory focuses on the interaction between a system and its environment, but it does not capture the dynamic and adaptive nature of current healthcare systems. Closed system theory suggests systems are self-contained and do not interact with the environment, which is not accurate for healthcare systems that constantly interact with patients, providers, and external factors. Chaos theory deals with complex systems and unpredictability, which while relevant to some aspects of healthcare, does not provide a comprehensive framework for understanding healthcare delivery systems.

2. What is the primary focus of case management in nursing?

• A. Direct patient care
• B. Resource management
• C. Financial planning
• D. Quality assurance

Correct answer: A

Rationale: The primary focus of case management in nursing is direct patient care, which involves providing and coordinating services for patients. While resource management, financial planning, and quality assurance are important aspects of healthcare, they are not the primary focus of case management. Resource management deals with optimizing resources, financial planning involves managing financial aspects, and quality assurance focuses on maintaining high standards of care.

3. The nurse manager compares the actual results of the budget with the projected results of the budget. What budgeting process is this?

• A. Variable budgeting
• B. Controlling
• C. Revenue sharing
• D. Incremental budgeting

Correct answer: B

Rationale: The correct answer is B: Controlling. Controlling involves comparing actual results with the projected results in the budget to assess performance and take corrective actions if necessary. Choice A, Variable budgeting, focuses on adjusting the budget based on activity levels. Choice C, Revenue sharing, refers to distributing a portion of revenue among stakeholders. Choice D, Incremental budgeting, involves making minor adjustments to the existing budget for the next period based on previous budgets.

4. A client is discussing the use of herbal supplements for health promotion with a nurse. Which of the following client statements indicates an understanding of herbal supplement use?

• A. I can take echinacea to improve my immune system.
• B. I can take feverfew to reduce my level of anxiety.
• C. I can take ginger to improve my memory.
• D. I can take ginkgo biloba to relieve nausea.

Correct answer: D

Rationale: The correct answer is D. Ginkgo biloba is commonly used to improve blood circulation and relieve symptoms of cognitive disorders like dementia. The other choices are incorrect because echinacea is used to boost the immune system, feverfew is used for migraines and headaches, and ginger is known for its anti-inflammatory properties and aiding digestion, not memory improvement.

5. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?

• A. Measure the ankle-brachial index.
• B. Check for changes in skin pigmentation.
• C. Assess for unilateral or bilateral foot drop.
• D. Ask the patient about symptoms of depression.

Correct answer: A

Rationale: The correct answer is A: Measure the ankle-brachial index. This task involves using a Doppler ultrasound device to assess blood flow, which can be safely delegated to UAP. Choices B, C, and D require a higher level of assessment and interpretation that should be performed by licensed nursing staff. Checking for changes in skin pigmentation (B) and assessing for foot drop (C) involve more complex assessments that require nursing judgment. Asking about symptoms of depression (D) involves a psychosocial assessment, which should be performed by licensed personnel qualified to address mental health concerns.

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