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.
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A new nurse manager is attempting to solve a management issue by using one solution after another until she solves the problem. This would be known as what type of method?
- A. Decision making
- B. Trial and error
- C. Experimentation
- D. Analysis
Correct Answer: B
Rationale: The correct answer is B: Trial and error. This method involves attempting different solutions sequentially until the problem is solved. Decision making (A) refers to making choices based on available information. Experimentation (C) involves testing hypotheses through controlled trials. Analysis (D) is the process of examining data and information to understand a situation. In this scenario, the nurse manager is not systematically testing hypotheses (experimentation), analyzing data (analysis), or making informed decisions (decision making), but rather trying different solutions until finding the one that works, which aligns with the trial and error method.
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.
During a home safety assessment, a nurse is evaluating a client who is receiving supplemental oxygen. Which observation should the nurse identify as a proper safety protocol?
- A. The client has a weekly inspection checklist for oxygen equipment.
- B. The client stores an extra oxygen tank on its side under their bed.
- C. The client identifies the location of a fire extinguisher.
- D. The client uses a wool blanket on their bed.
Correct Answer: A
Rationale: The correct answer is A because having a weekly inspection checklist for oxygen equipment ensures the client is monitoring the equipment regularly for safety. Choice B is incorrect as storing an oxygen tank on its side can be dangerous. Choice C is not directly related to oxygen safety. Choice D is incorrect because wool blankets can create static electricity, which is a fire hazard.
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.
An expensive variable in salary budgets is overtime pay. Which of the following is a viable option to reduce overtime?
- A. Limiting overtime for highly paid workers
- B. Reducing the number of beds
- C. Using per diem workers
- D. Refusing to pay overtime
Correct Answer: C
Rationale: The correct answer is C: Using per diem workers. This option is viable because per diem workers can be brought in to cover shifts without incurring overtime costs. By utilizing per diem workers, the organization can reduce the need for regular staff to work overtime hours, hence decreasing overall overtime expenses.
A: Limiting overtime for highly paid workers is not a practical solution as all workers, regardless of pay, may contribute to the need for overtime.
B: Reducing the number of beds may lead to reduced capacity and impact patient care, not directly addressing the issue of reducing overtime.
D: Refusing to pay overtime is not a sustainable solution as it may lead to legal issues and impact employee morale and productivity.
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