Nursing Elites

1. While supervising the care of several clients, which action requires intervention by the charge nurse?

• A. A nurse photocopies a client's diagnostic test results.
• B. An assistive personnel documents the client's vital signs on the client's paper-based graphic record.
• C. The unit secretary faxes a client's laboratory results to the provider.
• D. An RN stays with a client to discuss her understanding of her vital signs that were requested.

Correct answer: A

Rationale: The charge nurse should intervene when a nurse photocopies a client's diagnostic test results as it violates patient confidentiality and privacy. This action breaches HIPAA regulations, and sensitive patient information should not be photocopied without proper authorization. The other actions are within the scope of practice and do not raise concerns regarding patient privacy or confidentiality.

2. A healthcare provider is planning the discharge of a newborn who requires apnea monitoring at home. To which of the following community agencies should the healthcare provider anticipate referring the guardian of the newborn?

• A. Child Protective Services
• B. Public Health
• C. Home Health
• D. Women, Infants, and Children (WIC)

Correct answer: C

Rationale: Home health agencies specialize in providing at-home care and monitoring services, making them the appropriate referral for a newborn requiring apnea monitoring. These agencies can offer skilled nursing care, education, and support to ensure the well-being of the newborn in a home setting. Child Protective Services (Choice A) is not relevant in this scenario as it deals with child welfare and protection from abuse or neglect. Public Health (Choice B) focuses on community health initiatives but may not provide the specialized care needed for apnea monitoring. Women, Infants, and Children (WIC) program (Choice D) offers nutritional support and education for low-income pregnant women, new mothers, and young children, which is not directly related to providing monitoring services for a newborn with apnea.

3. When a nurse reads a peer-reviewed nursing journal article recommending a change in caring for a patient with an indwelling urinary catheter, which action demonstrates critical thinking?

• A. Implementing the article's recommendations in caring for a patient with an indwelling urinary catheter
• B. Presenting the journal article to the nurse manager and proposing a revision of the procedure
• C. Seeking additional peer-reviewed articles that corroborate the author's recommendation
• D. Disregarding the article and adhering to the facility's existing procedure

Correct answer: C

Rationale: Critical thinking involves evaluating information from various sources. In this scenario, the nurse displays critical thinking by seeking additional peer-reviewed articles that support the author's recommendation. This action ensures that decisions are based on a comprehensive understanding of the topic rather than relying solely on one source. By exploring other peer-reviewed articles, the nurse can validate the proposed change and make informed decisions regarding patient care. Choice A, implementing the article's recommendations, may not encompass a thorough evaluation of the information presented. Choice B, presenting the article to the nurse manager, is a valid step but does not directly involve critical analysis of the information. Choice D, disregarding the article, goes against the essence of critical thinking, which emphasizes the evaluation and consideration of various perspectives.

4. According to Watson's theory, how should the nurse manager deal with a staff member who has a substance addiction and is arriving at work under the influence of the substance?

• A. Send the nurse home with instructions not to return until clear of the substance.
• B. Call the police and have the nurse arrested for working while impaired.
• C. Confront the nurse privately, order drug testing, and suggest a substance abuse program.
• D. Notify the board of nursing and fire the nurse immediately.

Correct answer: C

Rationale: According to Watson's theory, a caring approach is essential. Confronting the nurse privately, ordering drug testing, and suggesting a substance abuse program demonstrates empathy and supports the staff member in seeking help for their addiction. This approach aligns with the principles of human caring and compassion, focusing on the well-being and recovery of the individual rather than punitive measures. Choices A and D are too harsh and lack empathy, not considering the individual's well-being or offering support for rehabilitation. Choice B is inappropriate and punitive, not aligned with a caring and compassionate approach as advocated by Watson's theory.

5. Nurses on a unit provide personal hygiene, administer medications, educate patients, and provide emotional support. The nurses are providing patient care based on which nursing delivery system?

• A. total patient care
• B. team nursing
• C. functional nursing
• D. partnership nursing

Correct answer: A

Rationale: The correct answer is A, total patient care. Total patient care refers to a nursing delivery system where one nurse is responsible for providing all aspects of care to the patient. In this system, the nurse assumes full responsibility for the patient's care, including personal hygiene, medication administration, patient education, and emotional support, ensuring comprehensive and individualized care. Choice B, team nursing, involves a team of healthcare providers working together to provide care to a group of patients. Choice C, functional nursing, divides tasks among different team members based on their skills and expertise. Choice D, partnership nursing, does not represent a recognized nursing delivery system, making it an incorrect option.

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