Nokea
A nurse has accepted a position as a clinical nurse leader (CNL), a new role that has been launched within the past decade. In this role, the nurse should prioritize which of the following activities?
- A. Acting as a spokesperson for the nursing profession
- B. Generating and disseminating new nursing knowledge
- C. Diagnosing and treating health problems that have a predictable course
- D. Helping patients to navigate the health care system
Correct Answer: D
Rationale: The CNL is a nurse generalist with a masters degree in nursing and a special background in clinical leadership, educated to help patients navigate through the complex health care system. The other answers are incorrect because they are not what nursing has identified as the CNL role.
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The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) are evaluating a large, university medical center according to core measures. Evaluators should perform this evaluation in what way?
- A. By auditing the medical centers electronic health records
- B. By performing focus groups and interviews with care providers from numerous disciplines
- C. By performing statistical analysis of patient satisfaction surveys
- D. By comparing the centers patient outcomes to best practice indicators
Correct Answer: D
Rationale: Core measures are used to gauge how well a hospital gives care to its patients who are admitted to seek treatment for a specific disease or who need a specific treatment as compared to evidence-based guidelines and standards of care. Benchmark standards of quality are used to compare the care or treatment patients receive with the best practice standards. Patient satisfaction is considered, but this is not the only criterion.
The role of the certified nurse practitioner (CNP) has become a dominant role for nurses in all levels of health care. Which of the following activities are considered integral to the CNP role? Select all that apply.
- A. Educating patients and family members
- B. Coordinating care with other disciplines
- C. Using direct provision of interventions
- D. Educating registered nurses and practical nurses
- E. Coordinating payment plans for patients
Correct Answer: A,B,C
Rationale: This role is a dominant one for nurses in primary, secondary, and tertiary health care settings and in home care and community nursing. Nurses help patients meet their needs by using direct intervention, by teaching patients and family members to perform care, and by coordinating and collaborating with other disciplines to provide needed services. The other answers are incorrect because NPs do not commonly perform education of nurses and they do not focus on matters related to payment.
Professional nursing expands and grows because of factors driven by the changing needs of health care consumers. Which of the following is a factor that nurses should reflect in the planning and provision of health care?
- A. Decreased access to health care information by individuals
- B. Gradual increases in the cultural unity of the American population
- C. Increasing mean and median age of the American population
- D. Decreasing consumer expectations related to health care outcomes
Correct Answer: C
Rationale: The decline in birth rate and the increase in lifespan due to improved health care have resulted in fewer school-age children and more senior citizens, many of whom are women. The population has become more culturally diverse as increasing numbers of people from different national backgrounds enter the country. Access to information and consumer expectations continue to increase.
A case manager has been hired at a rural hospital that has a combined medical-surgical unit. When defining this new role, which of the following outcomes should be prioritized by the hospitals leadership?
- A. Decreased need for physician services
- B. Improved patient and family education
- C. Increased adherence to the principles of EBP
- D. Increased coordination of health services
Correct Answer: D
Rationale: Case management is a system of coordinating health care services to ensure cost-effectiveness, accountability, and quality care. The case manager coordinates the care of a caseload of patients through facilitating communication between nurses, other health care personnel who provide care, and insurance companies. Reducing the need for physician services is not a central goal. Education and EBP are consistent with case management, but they are not central to this particular role.
A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Within this framework of understanding, what would be the nurses first priority?
- A. Allowing the family to see a newly admitted patient
- B. Ambulating the patient in the hallway
- C. Administering pain medication
- D. Teaching the patient to self-administer insulin safely
Correct Answer: C
Rationale: In Maslows hierarchy of needs, pain relief addresses the patients basic physiologic need. Activity, such as ambulation, is a higher level need above the physiologic need. Allowing the patient to see family addresses a higher level need related to love and belonging. Teaching the patient is also a higher level need related to the desire to know and understand and is not appropriate at this time, as the basic physiologic need of pain control must be addressed before the patient can address these higher level needs.