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What is the primary purpose of a patient-centered medical home (PCMH)?
- A. To coordinate all aspects of patient care
- B. To reduce healthcare costs
- C. To implement the latest clinical guidelines
- D. To provide financial incentives for providers
Correct Answer: A
Rationale: The primary purpose of a patient-centered medical home (PCMH) is to coordinate all aspects of patient care (Choice A). This model aims to improve patient outcomes by ensuring comprehensive and coordinated care that meets the individual's needs. PCMH focuses on enhancing patient-provider communication, care coordination, and patient engagement to deliver high-quality care. Choices B, C, and D are incorrect because while PCMH may indirectly contribute to reducing healthcare costs and implementing clinical guidelines, the main focus is on improving patient care coordination and quality outcomes. Providing financial incentives for providers is not the primary purpose of PCMH, but rather a potential outcome of improved care coordination.
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A registered nurse (RN) administered a patient’s morning insulin as the breakfast tray arrived at 0800. The RN performed a complete assessment at the same time. Then, the RN got busy with her other patients and did not check on the patient until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. Which of the following could the RN be charged with?
- A. Quasi-intentional tort
- B. Misdemeanor
- C. Negligence
- D. Juvenile offense
Correct Answer: C
Rationale: The correct answer is C: Negligence. The RN failed to monitor the patient after administering insulin, leading to a critical situation. Negligence in nursing involves a breach of duty of care that results in harm to the patient. In this case, the RN's failure to check on the patient for several hours directly contributed to the patient becoming unresponsive with dangerously low blood glucose levels. This constitutes a clear case of nursing negligence.
A: Quasi-intentional tort involves intentional actions that result in harm, such as defamation or invasion of privacy. This scenario does not involve intentional harm.
B: Misdemeanor refers to a criminal offense less serious than a felony. Negligence in nursing is typically addressed through civil, not criminal, proceedings.
D: Juvenile offense pertains to actions committed by minors. The RN is a healthcare professional, not a minor, and the offense here is related to professional negligence, not juvenile misconduct.
From a unit perspective, disruptive and violent patient behavior may be distracting to patients and staff. As the nurse manager, you are concerned about: (EXCEPT)
- A. Patient and staff safety.
- B. Team tension.
- C. Fear of disappointment.
- D. Stress levels.
Correct Answer: C
Rationale: The correct answer is C: Fear of disappointment. As a nurse manager, concerns should be focused on patient and staff safety (A), team tension (B), and stress levels (D) due to disruptive and violent patient behavior. Fear of disappointment is not directly related to the immediate impact on safety, team dynamics, or stress levels in this scenario. It is important to prioritize addressing safety risks, maintaining team cohesion, and managing stress levels to ensure a safe and effective healthcare environment.
Which question during the assessment of a diabetic patient will help the nurse identify
autonomic neuropathy?
- A. “Do you feel bloated after eating?”
- B. “Have you seen any skin changes?”
- C. “Do you need to increase your insulin dosage when you are stressed?”
- D. “Have you noticed any painful new ulcerations or sores on your feet?”
Correct Answer: A
Rationale: Rationale: Autonomic neuropathy affects digestion, leading to bloating after eating. This symptom is related to the dysfunction of the autonomic nervous system. Skin changes, insulin dosage changes due to stress, and new ulcerations are not specific to autonomic neuropathy. Bloated feeling after eating is a classic symptom of autonomic neuropathy due to impaired gastrointestinal motility.
When considering virtue ethics, which of the following is true?
- A. Virtue ethics attributes behaviors to moral rules.
- B. Virtue ethics attributes behaviors to knowledge of consequences.
- C. Virtue ethics focuses on moral character, rather than rules for behavior.
- D. Virtue ethics is a formal statement of rules for behavior.
Correct Answer: C
Rationale: The correct answer is C because virtue ethics focuses on developing moral character rather than following strict rules. Virtue ethics emphasizes cultivating good habits and virtues to guide behavior. This approach values the inherent qualities of a person rather than relying on external rules or consequences. Option A is incorrect as virtue ethics does not rely on fixed moral rules. Option B is incorrect as virtue ethics does not base behavior solely on knowledge of consequences. Option D is incorrect as virtue ethics does not provide a formal statement of rules but rather encourages individuals to embody virtuous traits.
1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?
- A. Blood pressure
- B. Serum creatinine
- C. Chest x-ray
- D. Urine for microalbuminuria
Correct Answer: C
Rationale: Step-by-step rationale for correct answer (C):
1. Chest x-ray is not routinely recommended for monitoring complications of type 2 diabetes.
2. Annual blood pressure monitoring is crucial for assessing cardiovascular risk in diabetic patients.
3. Serum creatinine test helps evaluate kidney function, which is often impaired in diabetes.
4. Urine microalbuminuria test detects early signs of kidney damage, common in diabetes.
Summary of incorrect choices:
A: Blood pressure monitoring is essential for assessing cardiovascular risk in diabetes.
B: Serum creatinine test is important for evaluating kidney function in diabetic patients.
D: Urine microalbuminuria test helps detect early kidney damage in diabetes.