An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?

Correct Answer: B

Rationale: The correct answer is B because a blood pressure of 146/88 mmHg indicates hypertension, which is a common complication of diabetes. High blood pressure can lead to cardiovascular complications and may warrant a change in therapy. A: Hemoglobin A1C level 6.2% is within the target range for diabetes control. C: Resting heart rate of 58 beats/minute is within the normal range for an active individual. D: HDL level of 65 mg/dL is considered high and is actually beneficial for cardiovascular health.

Correct Answer: B

Rationale: The correct answer is B because a blood pressure of 146/88 mmHg indicates hypertension, which is a common complication of diabetes. High blood pressure can lead to cardiovascular complications and may warrant a change in therapy. A: Hemoglobin A1C level 6.2% is within the target range for diabetes control. C: Resting heart rate of 58 beats/minute is within the normal range for an active individual. D: HDL level of 65 mg/dL is considered high and is actually beneficial for cardiovascular health.

Correct Answer: D

Rationale: The correct answer is D: Contingency theory. Contingency theory suggests that there is no one best way to organize and manage a healthcare system. It emphasizes that the effectiveness of a healthcare delivery system depends on various factors such as the environment, technology, and organizational structure. This theory acknowledges the complexity of healthcare systems and the need for flexibility and adaptation to changing circumstances. A: Open system theory focuses on the system's interaction with its environment, but it does not specifically address the best way to organize and manage a healthcare system. B: Closed system theory suggests that a system is self-contained and not influenced by external factors, which is not suitable for describing healthcare delivery systems. C: Chaos theory emphasizes the unpredictability and complexity of systems, but it does not provide a framework for organizing and managing healthcare systems effectively.

Correct Answer: B

Rationale: The correct answer is B: Beneficence and nonmaleficence. Beneficence refers to doing good and nonmaleficence refers to avoiding harm. Technology can create ethical conflicts because advancements may aim to benefit individuals (beneficence) but could also potentially cause harm (nonmaleficence). Other choices are incorrect: A) Justice is about fairness in distribution, not in conflict with beneficence; C) Veracity is truth-telling, not in direct conflict with beneficence; D) Confidentiality involves privacy, which is not directly in conflict with beneficence.

Correct Answer: C

Rationale: The correct answer is C: Shared decision making. Shared governance involves collaborative decision-making among healthcare professionals, including nurses, to improve patient care and organizational outcomes. This approach empowers frontline staff to have a voice in decisions that affect their work environment and patient care. Nurse-led committees (option B) may be a part of shared governance but do not fully encompass the concept. Top-down management (option A) and hierarchical structure (option D) are opposite to the principles of shared governance as they involve centralized decision-making and lack of employee involvement in decision-making processes.

Correct Answer: B

Rationale: The correct answer is B: Capital budget. A capital budget is used for long-term investments in assets like equipment and facilities, such as hospital beds. This type of budget is for significant expenditures that have a lasting impact on the organization. Operating budget (A) covers day-to-day expenses, not major purchases. Salary budget (C) is for staffing costs, not equipment purchases. Revenue budget (D) focuses on projected income, not capital expenditures. Therefore, the capital budget is the appropriate choice for buying new hospital beds.

Correct Answer: C

Rationale: The correct answer is C: Time wasters. The manager missed the deadline due to distractions such as answering phone calls, checking emails, and engaging with staff, which are all considered time-wasting activities. These distractions prevented him from focusing on the task at hand, leading to missing the deadline. Goal setting (choice A) is about defining objectives, not the immediate cause of missing the deadline. Organization (choice B) refers to structuring tasks efficiently, which the manager failed to do. Assertiveness (choice D) relates to standing up for oneself and making decisions, not the primary reason for missing the deadline in this scenario.

Correct Answer: D

Rationale: The correct answer is D: Patient-focused. Developing a patient-focused atmosphere is crucial to reduce potential risks in healthcare. Patients should be at the center of care, with their needs, preferences, and safety prioritized. In a patient-focused atmosphere, communication is enhanced, leading to better understanding and adherence to treatment plans, reducing errors and adverse events. Nurses, physicians, and families play important roles in patient care, but ultimately, the patient should be the primary focus. Incorrect choices: A: Nurse-focused - Focusing solely on nurses may neglect the holistic approach to patient care and fail to address the patient's needs directly. B: Physician-focused - Similarly, focusing only on physicians may lead to a lack of patient involvement in decision-making and may not address the emotional and psychological aspects of care. C: Family-focused - While involving families in care is important, solely focusing on them may not always align with the patient's best interests and may not address the patient's autonomy and individual needs.

Correct Answer: C

Rationale: The main focus of a clinical governance framework is patient care quality. This is because clinical governance aims to ensure that healthcare services provided are safe, effective, and of high quality. By focusing on patient care quality, healthcare organizations can improve outcomes and patient satisfaction. Financial performance (A) is important but not the main focus. Regulatory compliance (B) is necessary but not the primary goal. Staff satisfaction (D) is important for a positive work environment, but it is not the main focus of a clinical governance framework.