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. What skills are required for an LPN to successfully manage care?

• A. The ability to organize and prioritize tasks
• B. The ability to work weekends and off shifts
• C. The ability to develop a comprehensive care plan
• D. Close relationship with the supervising RN

Correct answer: A

Rationale: To successfully manage care as an LPN, one must possess the ability to organize and prioritize tasks. This skill is crucial in ensuring efficient and effective care delivery, as it helps in planning, coordinating, and addressing patient needs in a timely manner. While the other choices may also be important in certain contexts, the key skill required for care management is the ability to organize and prioritize tasks. Working weekends and off shifts (Choice B) may be part of the job requirement but is not a skill. Developing a comprehensive care plan (Choice C) is important but falls more under the domain of care planning rather than day-to-day care management. Having a close relationship with the supervising RN (Choice D) is beneficial for collaboration but is not a standalone skill required for managing care.

3. On what basis does the U.S. healthcare system operate?

• A. Healthcare is a basic right provided to all equally.
• B. Ability to pay determines access to care.
• C. Only the rich are entitled to healthcare.
• D. Health insurance is required to obtain care.

Correct answer: B

Rationale: The correct answer is B. In the U.S., the healthcare system operates on a model where access to healthcare services is largely determined by an individual's ability to pay for care. This means that those with more financial resources have greater access to a wider range of healthcare services, while those with limited financial means may face barriers to accessing necessary care. Choices A, C, and D are incorrect because healthcare in the U.S. is not universally provided as a basic right to all equally, it is not exclusively for the rich, and while health insurance is common, it is not the sole determinant of access to care.

4. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

5. Which action directly resulted from the contribution made by Linda Richards?

• A. Using an antiseptic before administering an injection
• B. Exploring the psychosocial needs of the patient
• C. Documenting patient care in the medical record
• D. Listening to a patient describe his or her symptoms

Correct answer: C

Rationale: The correct answer is C: Documenting patient care in the medical record. Linda Richards' contribution was developing a system for recording patient details and care, leading to modern medical records. This innovation directly resulted in the practice of documenting patient care in medical records, ensuring accurate and organized patient information for effective healthcare delivery. Choices A, B, and D are incorrect because they do not directly stem from Richards' specific contribution related to medical records.

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