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 group of local volunteers has completed an emergency response course and is able to assist with the triage of injured citizens. They also participate in local health fairs to teach residents how to react during tornadoes. The responders are members of what organization?

• A. Metropolitan Medical Response System (MMRS)
• B. Medical Reserve Corps (MRC)
• C. National Disaster Medical System (NDMS)
• D. Commissioned Corps Readiness Force (CCRF)

Correct answer: B

Rationale: The Medical Reserve Corps (MRC) is the correct answer. This group consists of local volunteers who have completed emergency response training and are able to assist in the triage of injured citizens. Additionally, they participate in local health fairs to educate residents on tornado response procedures. The other choices are incorrect: MMRS (Metropolitan Medical Response System) focuses on coordinating resources for mass casualty incidents, NDMS (National Disaster Medical System) is a federally coordinated system for medical response during disasters, and CCRF (Commissioned Corps Readiness Force) is part of a specific governmental service branch.

3. Which title identifies a nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers?

• A. Team leader in nursing care delivery
• B. Case manager
• C. Nurse manager
• D. Coordinator of patient-centered care delivery

Correct answer: B

Rationale: The correct answer is B: Case manager. A case manager plays a crucial role in coordinating a patient's care across different healthcare settings and providers to ensure continuity, efficiency, and optimal outcomes. They work closely with various members of the healthcare team to facilitate a comprehensive care plan and address the patient's needs throughout their healthcare journey. Choice A is incorrect because a team leader in nursing care delivery focuses more on supervising a team of nurses rather than patient care coordination. Choice C, Nurse manager, typically oversees a nursing unit or department but may not have the primary role of coordinating a patient's care. Choice D, Coordinator of patient-centered care delivery, though related, does not specify the direct responsibility of following a patient from admission to discharge or resolution of illness.

4. The nurse is providing pre-operative teaching to the anxious patient, who doesn't seem to be learning. What need must the nurse help this patient meet before continuing to teach?

• A. Self-esteem
• B. Love and belonging
• C. Safety
• D. Self-actualization

Correct answer: C

Rationale: The correct answer is C: Safety. Before effective learning can occur, the patient's safety needs must be addressed. When patients feel safe and secure, they are better able to focus on receiving and processing information. Ensuring the patient's safety is a fundamental step in providing care and support, especially in a pre-operative setting where anxiety and concerns about the procedure may be high. Choices A, B, and D are incorrect because while self-esteem, love and belonging, and self-actualization are important needs, the immediate priority in this scenario is addressing the patient's safety concerns to create a conducive environment for learning.

5. 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.

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