Nursing Elites

1. 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.

2. 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.

3. 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.

4. The healthcare provider responds to an alarm on a pulse oximeter and sees that the patient's oxygen saturation is reading 38%. The provider observes the patient, noting a respiratory rate of 12 breaths per minute, pink mucous membranes, and easy regular respirations. The healthcare provider concludes that the pulse oximeter is not reading accurately. Whose theory of healthcare is this provider demonstrating?

• A. Annie Goodrich
• B. Lillian D. Wald
• C. Florence Nightingale
• D. Linda Richards

Correct answer: C

Rationale: Florence Nightingale emphasized the importance of assessing the patient's overall condition and not solely relying on technological readings. In this scenario, the healthcare provider's observation of the patient's respiratory rate, mucous membranes, and breathing pattern aligns with Nightingale's holistic approach to patient care. Annie Goodrich is known for her contributions to nursing education; Lillian D. Wald is associated with public health nursing and social reform; Linda Richards is recognized as America's first trained nurse. However, in this context, the emphasis is on the holistic patient assessment, which is a key principle of Florence Nightingale's theory.

5. 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.

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