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A bill is pending in the state legislature that will mandate teaching health promotion related to smoking cessation. Which action by the nurse should have the greatest impact on passage of the bill?
- A. Explain the rationale for the bill to the school board.
- B. Contact the elected representative's office by telephone to request support for the bill.
- C. Support a health advocate to run for election as state representative.
- D. Tell all students about the bill.
Correct Answer: B
Rationale: The correct answer is B: Contact the elected representative's office by telephone to request support for the bill. This action is the most direct and effective way to influence the passage of the bill. By directly contacting the elected representative, the nurse can advocate for the importance of the bill and provide relevant information to garner their support. This direct communication with the decision-maker holds significant weight in influencing their vote on the bill.
A: Explaining the rationale to the school board may be informative, but the school board may not have direct influence on the state legislature.
C: Supporting a health advocate to run for election is a long-term strategy and may not have an immediate impact on the passage of the bill.
D: Telling all students about the bill may raise awareness but may not directly influence the lawmakers' decisions.
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A new graduate nurse is preparing for an interview for her first position and knows that: (select all that apply)
- A. the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school.
- B. appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position.
- C. self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners.
- D. work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio.
Correct Answer: A
Rationale: The correct answer is A because the primary goal for a new graduate nurse in their first job is to successfully complete the orientation process. This is crucial for transitioning from the academic setting to the professional nursing environment. Completing orientation ensures that the nurse is equipped with the necessary knowledge and skills to provide safe and effective patient care.
Choice B is incorrect because scheduling interviews immediately after graduation may not allow the nurse enough time to prepare adequately for the interview process.
Choice C is incorrect because while self-confidence is important, relying solely on past achievements of peers may not be a sustainable source of confidence in a new work environment.
Choice D is incorrect because while work history and letters of recommendation can be valuable, they may not necessarily be the primary focus during the initial stages of a new nurse's career.
Which of the following statements concerning the Institute of Medicine (IOM) competencies is correct?
- A. Each competency is mutually exclusive.
- B. The competencies focus on individual efforts to reduce errors.
- C. Physicians lead the team to achieve each competency.
- D. The competencies address both individual and system approaches to transform care.
Correct Answer: D
Rationale: The correct answer is D because the IOM competencies aim to improve healthcare by addressing both individual and system-based approaches. This is crucial as it recognizes that improving healthcare requires a comprehensive approach that involves changing both individual behaviors and systemic structures. A: Each competency is mutually exclusive - This is incorrect as the competencies are designed to work together, not in isolation. B: The competencies focus on individual efforts to reduce errors - This is incorrect as the competencies also emphasize the importance of systemic changes to prevent errors. C: Physicians lead the team to achieve each competency - This is incorrect as the competencies are meant to be achieved collaboratively by a multidisciplinary team, not solely led by physicians.
A client is hypertensive, and the doctor prescribes weight reduction. The client is excited about beginning the diet, but on arriving home the spouse states, "You have always been fat, and I am not going to starve because you can't control yourself." The client becomes anxious and is unable to participate in the diet plan, resulting in a weight gain of 5 pounds in 2 weeks. Which theorist could best be referred to for guidance regarding interventions in this situation?
- A. Martha E. Rogers
- B. Hildegard E. Peplau
- C. Florence Nightingale
- D. Myra Estrin Levine
Correct Answer: B
Rationale: The correct answer is B: Hildegard E. Peplau. Peplau's nursing theory focuses on interpersonal relations, emphasizing the nurse-client relationship. In this situation, the client's anxiety and inability to participate in the diet plan are directly related to the negative interaction with the spouse. Peplau's theory suggests that the nurse can intervene by providing emotional support, facilitating communication, and helping the client manage anxiety. Rogers' theory focuses on the science of unitary human beings, which is not directly applicable here. Nightingale's theory emphasizes environmental factors, not interpersonal relationships. Levine's theory focuses on conservation principles, which are not directly relevant to addressing the client's anxiety and relational issues. Therefore, Peplau's theory best guides interventions in this situation.
A nurse is asked to "float" to another area where the patients require total care. The nurse smiles, picks up her stethoscope, and says, "I'll come back and eat lunch with everyone here." When she enters the elevator she hits the wall and mutters, "Always me. Don't I have any rights"? The nurse is demonstrating which communication style?
- A. Assertive
- B. Aggressive
- C. Passive
- D. Passive-aggressive
Correct Answer: D
Rationale: The correct answer is D, passive-aggressive. The nurse is indirectly expressing her displeasure and resistance to floating by smiling and agreeing to come back for lunch, but then displaying negative body language and muttering under her breath. This behavior is passive on the surface but aggressive in the underlying tone. The nurse is not openly confronting the issue but is still showing resistance and frustration.
A: Assertive communication involves expressing one's needs and feelings in a direct and respectful manner. The nurse is not openly communicating her feelings or needs in this scenario.
B: Aggressive communication involves expressing needs and feelings in a forceful and hostile manner. The nurse's behavior is not openly hostile towards others.
C: Passive communication involves avoiding conflict and not expressing one's needs or feelings. The nurse is indirectly expressing her displeasure, so it's not purely passive.
An older adult woman who stops using complementary alternative medicine (CAM) becomes disoriented and is given a diagnosis of dementiThe family is upset with the family physician and the CAM practitioner for not diagnosing the condition earlier. Which CAM may have interfered with early detection of the dementia?
- A. Large doses of calcium caused cerebral plaques to form, thereby disguising atrophy of the brain.
- B. Excess doses of folic acid masked a vitamin B deficiency that led to dementia.
- C. Hypnotherapy focused on current pleasant thoughts, eliminating clues to the past.
- D. The electrical current from magnetic fields interfered with normal brain waves, resulting in confusion and inability to concentrate.
Correct Answer: A
Rationale: The correct answer is A because large doses of calcium causing cerebral plaques to form can potentially mask the atrophy of the brain, which is a common indicator of dementia on imaging studies. This interference could delay the detection of dementia.
Choice B is incorrect because excess folic acid would not mask a vitamin B deficiency that could lead to dementia. Choice C is incorrect as hypnotherapy focusing on current thoughts would not necessarily eliminate clues to past cognitive decline. Choice D is incorrect because there is no evidence that the electrical current from magnetic fields interferes with normal brain waves in a way that would cause confusion and inability to concentrate.