Nursing Elites

1. A client with a terminal illness is concerned about performing self-care after discharge. Which of the following statements should the nurse make?

• A. A social worker will address your concerns after discharge.
• B. You should plan to go to a skilled nursing facility after discharge.
• C. Your case manager will coordinate the resources you will need.
• D. You will need hospice care until you feel stronger.

Correct answer: C

Rationale: In this scenario, the most appropriate statement for the nurse to make is that the case manager will coordinate the resources needed for self-care after discharge. Case managers are responsible for organizing and ensuring the provision of necessary resources and services to support the patient's care plan, making this the best option among the choices provided. Social workers typically address psychosocial concerns, skilled nursing facilities are for more intensive care needs, and hospice care is usually for end-of-life care, making them less suitable responses in this context.

2. The increasing use of licensed practical nurses (LPNs) in management positions, especially in long-term care facilities, is an example of what?

• A. Assertive management
• B. A shifting paradigm
• C. Critical thinking
• D. Smarter LPN graduates

Correct answer: B

Rationale: The correct answer is B: A shifting paradigm. The increasing use of LPNs in management positions, particularly in long-term care facilities, represents a changing paradigm in healthcare management. This shift indicates a move towards assigning leadership responsibilities to LPNs, signaling a departure from traditional industry roles. Choices A, C, and D are incorrect because the situation described does not primarily demonstrate assertive management, critical thinking, or the intelligence of LPN graduates. The focus is on the evolving role of LPNs in management, suggesting a broader change in healthcare practices.

3. What term is used to identify the care delivery model being used when a nurse makes patient care assignments as follows: RN1 has rooms 202-210, RN2 has rooms 211-221, RN3 has rooms 222-232. The unlicensed assistive personnel have half the rooms, with one assigned to 202-215 and the second to 216-232?

• A. Partnership
• B. Primary
• C. Modular
• D. Team

Correct answer: C

Rationale: The term used to identify the care delivery model being used in this scenario is 'Modular.' In modular nursing, a nursing unit is divided into modules, with each module staffed by a team assigned to specific rooms. This division allows for a more organized and efficient delivery of care, with clear assignments and responsibilities for each team. Choices A, B, and D are incorrect. Partnership typically refers to collaboration between healthcare providers; Primary is related to the patient's main healthcare provider; and Team is a general term that does not specifically describe the modular care delivery model outlined in the question.

4. How do accrediting agencies such as the Joint Commission ensure quality care?

• A. Imposing maximum staffing levels
• B. Stipulating nurse-patient ratios
• C. Confirming delivery of satisfactory care
• D. Requiring a specific staff mix

Correct answer: C

Rationale: Accrediting agencies such as the Joint Commission primarily focus on confirming the delivery of satisfactory care rather than imposing specific staffing levels, nurse-patient ratios, or staff mix. They do not dictate the exact staffing levels or ratios but rather evaluate if the care provided meets established quality standards. While adequate staffing levels and appropriate nurse-patient ratios are essential for quality care, accrediting agencies like the Joint Commission assess the outcomes and overall quality of care delivered by healthcare facilities.

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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