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. Quality management and benchmarking are two approaches used to improve the quality of care. The major difference between these two approaches is which of the following?

• A. Quality management is not useful in the outpatient setting
• B. Benchmarking compares outcomes in a variety of settings and disciplines
• C. Quality management is used only in the primary care setting
• D. Benchmarking looks only at outcomes specific to nursing

Correct answer: B

Rationale: The major difference between quality management and benchmarking is that benchmarking compares outcomes in a variety of settings and disciplines. Choice A is incorrect because quality management can be applied in both inpatient and outpatient settings. Choice C is incorrect as quality management is not limited to primary care and can be implemented across various healthcare settings. Choice D is incorrect as benchmarking does not solely focus on nursing outcomes but rather compares outcomes across different disciplines and settings.

3. A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?

• A. Perceived conflict
• B. Disruptive conflict
• C. Competitive conflict
• D. Felt conflict

Correct answer: B

Rationale: The behavior displayed by the resident and the nurse is an example of disruptive conflict. In disruptive conflict, the parties involved engage in activities to reduce, defeat, or eliminate the opponent. The resident refusing to answer calls and the nurse retaliating with frequent calls to 'get back' at him exemplify behaviors aimed at causing disruption and conflict between them. Perceived conflict refers to each party's perception of the other's position, competitive conflict involves one side winning at the expense of the other, and felt conflict is about the feelings of opposition within the relationship, none of which fully capture the nature of the conflict displayed in this scenario.

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 theory views motivation as learning?

• A. Reinforcement
• B. Process
• C. Operant
• D. Conditioning

Correct answer: A

Rationale: The correct answer is A, Reinforcement. Reinforcement theory views motivation as learning through the association of behaviors with consequences. Choice B, Process, is too vague and does not specifically relate motivation to learning. Choice C, Operant, is a type of conditioning that focuses on voluntary behavior and its consequences, not motivation as learning. Choice D, Conditioning, is a general term that does not directly connect motivation with learning.

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