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. Caring means responding to others as unique individuals, sensing their emotions, and accepting them as they are, unconditionally. This response accepts the patient's choice without condemning or frightening them.

• A. Finding a way for the patient to see the dog, even if they can only look out a window, shows caring by understanding this patient's needs.
• B. The definition of transpersonal caring includes accepting individuals for who they are, so a nonjudgmental attitude is essential.
• C. This statement includes the patient in planning care, demonstrating care for the patient's needs and preferences.
• D. Curative nursing care is high-tech, or nursing care that is based on the medical model of care, which often is based on the use of technology.

Correct answer: C

Rationale: The statement in option C aligns with the concept of caring described in the question. By including the patient in planning care, it demonstrates an understanding of and respect for the patient's individual needs and preferences. This approach fosters a patient-centered care environment, promoting better outcomes and patient satisfaction. Options A and B touch on aspects of caring but do not directly address the scenario described in the question. Option D introduces a different concept, curative nursing care, which is not relevant to the context of the question focused on patient-centered caring and acceptance.

3. 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.

4. In a unionized hospital, nurses receive compensatory pay for working holidays based on the hours worked with no extra compensation. Despite management refusing to consider changes to the compensatory pay system suggested by nurses during the annual employee satisfaction survey, a trend member listened to both parties and made non-legally binding recommendations. What is this type of settlement known as?

• A. Collective bargaining
• B. Mediation
• C. Grievance
• D. Binding arbitration

Correct answer: B

Rationale: Mediation involves a neutral third party who assists in resolving disputes by providing non-legally binding recommendations. In this scenario, the trend member acted as a mediator by listening to both nurses and management and offering suggestions without the authority to enforce them as a legally binding decision. Collective bargaining refers to negotiations between labor unions and employers to determine terms of employment. Grievance is a formal complaint by an employee against an employer. Binding arbitration involves a neutral third party making a final and legally binding decision to resolve a dispute.

5. Which historical figure is honored for working to improve care for the mentally ill?

• A. Clara Barton
• B. Florence Nightingale
• C. Dorothea Dix
• D. Lillian D. Wald

Correct answer: C

Rationale: Dorothea Dix is the correct answer. She is recognized for her significant contributions in advocating for the improvement of care for the mentally ill. Dorothea Dix played a crucial role in transforming the way individuals with mental illnesses were treated, advocating for better living conditions and appropriate care. Her efforts led to improved standards and treatment practices for the mentally ill. Clara Barton is known for her role in founding the American Red Cross, Florence Nightingale is renowned as a pioneer in modern nursing, and Lillian D. Wald is recognized for her work in public health and social reform, but they are not specifically honored for their work in improving care for the mentally ill.

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