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. A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?

• A. ''I had a bowel movement, but I was able to save the urine.''
• B. ''I have a specimen in the bathroom from about 30 minutes ago.''
• C. ''I drink a lot, so I will fill up the bottle and complete the test quickly.''
• D. ''I flushed what I urinated at 7:00 a.m. and have saved all urine since.''

Correct answer: C

Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.

3. One of the perceptions of turnover is:

• A. Poor management
• B. Rejection of the job
• C. Loss of poor performers
• D. Poor job atmosphere

Correct answer: B

Rationale: The correct answer is B: 'Rejection of the job.' According to Steers and Stone, turnover can be perceived by coworkers as a rejection of the job. Choice A, 'Poor management,' is incorrect because turnover perception is more related to individual feelings about the job rather than management. Choice C, 'Loss of poor performers,' is incorrect as it focuses on the outcome of turnover rather than the perception. Choice D, 'Poor job atmosphere,' is incorrect as it describes a cause of turnover rather than a perception.

4. Which of the following best describes the purpose of a root cause analysis (RCA)?

• A. Identify the person responsible for an error
• B. Determine who should be disciplined
• C. Discover the underlying causes of an error
• D. Evaluate the effectiveness of a new policy

Correct answer: C

Rationale: The correct answer is C: 'Discover the underlying causes of an error.' Root cause analysis (RCA) focuses on identifying the fundamental reason(s) that led to an error or problem rather than placing blame on individuals. Choice A and B are incorrect as RCA is not about pinpointing a specific person to blame or determining disciplinary actions. Choice D is also incorrect as the primary goal of RCA is not to evaluate policy effectiveness but to uncover the root causes of issues for effective problem-solving.

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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