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The changes brought forth by the state boards of nursing are an example of which type of change agent?
- A. Resistance
- B. Empirical-rational
- C. Normative-reeducative
- D. Power-coercive
Correct Answer: D
Rationale: The correct answer is D: Power-coercive. State boards of nursing have the authority to enforce regulations and standards through legal power, making them a power-coercive change agent. They can mandate compliance and impose consequences for non-compliance, utilizing their regulatory power to drive change.
A: Resistance is incorrect as state boards of nursing do not resist change but rather implement and enforce it.
B: Empirical-rational is incorrect as this approach involves presenting data and information to persuade individuals to change, which may not align with the state boards' regulatory enforcement.
C: Normative-reeducative is incorrect as it focuses on changing beliefs and values through education and social influence, which is not the primary method used by state boards of nursing for implementing change.
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A nurse is admitting a client who has an abdominal wound with a large amount of purulent drainage. Which of the following types of transmission precautions should the nurse initiate?
- A. Droplet precautions
- B. Protective environment
- C. Airborne precautions
- D. Contact precautions
Correct Answer: D
Rationale: The correct answer is D: Contact precautions. This is because purulent drainage indicates the presence of infectious material that can easily be transmitted through direct contact. By implementing contact precautions, the nurse can prevent the spread of infection to themselves and others. Droplet precautions (A) are used for pathogens spread through respiratory droplets, protective environment (B) is used for immunocompromised patients, and airborne precautions (C) are used for pathogens that remain suspended in the air. These precautions are not relevant to the situation described with purulent drainage.
A staff nurse is working with a patient who is on a critical pathway for education in preparation for home care. Which one of the following responsibilities would the nurse address first?
- A. Taking vital signs
- B. Answering the client's questions
- C. Evaluating client teaching
- D. Reviewing the information with the client and family
Correct Answer: D
Rationale: The correct answer is D because reviewing the information with the client and family should be addressed first to ensure understanding and clarity. This step allows for immediate feedback and corrections if needed, promoting effective education. Taking vital signs (A) can be done after educating the client. Answering questions (B) and evaluating teaching (C) come after providing the necessary information.
A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?
- A. Hemoglobin A1C level is 7.9%.
- B. Last eye exam was 18 months ago.
- C. Glomerular filtration rate is decreased.
- D. Patient has questions about the prescribed diet.
Correct Answer: C
Rationale: The correct answer is C: Glomerular filtration rate is decreased. This finding is most important to discuss because metformin can potentially worsen kidney function, especially in older adults. A decreased GFR could indicate renal impairment, making it necessary to reevaluate the medication regimen.
A: Hemoglobin A1C level is 7.9% - While this indicates poor diabetic control, it is not as urgent as addressing potential renal issues with metformin.
B: Last eye exam was 18 months ago - While regular eye exams are important for diabetic patients, it is not as critical as addressing renal function.
D: Patient has questions about the prescribed diet - While patient education is crucial, it is not as urgent as addressing potential renal complications.
In summary, the priority is to address the decreased GFR to ensure the patient's safety and well-being.
When matching a job with an experienced RN, what is the first step in the selection process?
- A. Job analysis
- B. Selection techniques
- C. Methods of recruiting
- D. Assurance of legal requirements
Correct Answer: A
Rationale: The correct answer is A: Job analysis. This is the first step in the selection process as it involves identifying the specific duties, responsibilities, and requirements of the job. By conducting a job analysis, an organization can ensure that they have a clear understanding of what the job entails, which is crucial for effectively matching it with an experienced RN.
Choice B, selection techniques, comes after job analysis and involves determining the most appropriate methods for evaluating candidates. Choice C, methods of recruiting, focuses on attracting candidates and is not the first step in the selection process. Choice D, assurance of legal requirements, is important but typically occurs later in the process after job analysis has been completed.
Which of the following presents an important emerging challenge to changes in health care?
- A. Decreased immigration
- B. Nursing staff shortages
- C. Bioterrorism
- D. Increased surgical procedures
Correct Answer: C
Rationale: The correct answer is C: Bioterrorism. This is because bioterrorism poses a serious threat to public health and healthcare systems worldwide, requiring preparedness and response strategies.
- A: Decreased immigration is not a significant emerging challenge to changes in healthcare.
- B: Nursing staff shortages are an ongoing issue but not necessarily a new emerging challenge.
- D: Increased surgical procedures may strain resources but are not a specific emerging challenge like bioterrorism.