Nursing Elites

1. During preoperative teaching for a client scheduled for a total knee arthroplasty who speaks a different language than the nurse, which interprofessional team member should the nurse include in the discussion?

• A. Interpreter
• B. Social worker
• C. Occupational therapist
• D. Spiritual advisor

Correct answer: A

Rationale: In this scenario, the nurse should include an interpreter in the discussion to facilitate clear and accurate communication between the nurse and the client who speaks a different language. The interpreter plays a crucial role in ensuring that the client fully understands the preoperative teaching and can express any concerns or questions effectively. Choice B, a social worker, is not the most appropriate option in this context as the primary need is language interpretation rather than social support. Choice C, an occupational therapist, is also not the best option as their role does not directly address the language barrier issue. Choice D, a spiritual advisor, is not relevant to the situation at hand and would not assist in overcoming the language barrier.

2. A patient is admitted with pneumonia. My case manager refers to a plan of care that specifically identifies dates when supplemental oxygen should be discontinued, positive pressure ventilation with bronchodilators should be changed to self-administer inhalers, and antibiotics should be changed from intravenous to oral treatment, based on assessment findings. This plan of care is referred to by what term?

• A. patient classification system
• B. patient-centered plan of care
• C. diagnosis-related group
• D. clinical pathway

Correct answer: D

Rationale: A clinical pathway is a structured, evidence-based plan that outlines the expected course of treatment and interventions for a specific diagnosis or procedure, in this case, pneumonia. It includes guidelines on the timing of interventions and transitions in care based on assessment findings, promoting standardized care and improved outcomes for patients. The other choices are incorrect: A) patient classification system categorizes patients based on similar characteristics; B) patient-centered plan of care focuses on individual patient needs and preferences; C) diagnosis-related group is a classification system used for billing purposes.

3. Why is critical thinking necessary for identifying and understanding paradigms that exist in nursing practice?

• A. Critical thinking allows for the nurse to make superficial decisions.
• B. Critical thinking allows the nurse to thoroughly examine situations and issues.
• C. Critical thinking provides the nurse with quick answers.
• D. Critical thinking allows the nurse to accept information without needing to check its validity.

Correct answer: B

Rationale: Critical thinking is essential for nurses to identify and understand paradigms in nursing practice because it enables them to thoroughly examine complex situations and issues. By critically analyzing information and considering various perspectives, nurses can gain a deeper understanding of the underlying paradigms that shape nursing practice. This thorough examination helps nurses make informed decisions and provide high-quality care to patients. Choice A is incorrect because critical thinking involves deeper analysis, not superficial decisions. Choice C is incorrect because critical thinking does not provide quick answers; it involves a systematic and thoughtful approach. Choice D is incorrect because critical thinking encourages nurses to question information and verify its validity rather than accepting it blindly.

4. 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.

5. What is the primary focus of the Patient Protection and Affordable Care Act?

• A. Reducing the cost of healthcare
• B. Providing healthcare to undocumented immigrants
• C. Ensuring access to healthcare for all Americans
• D. Eliminating the need for health insurance

Correct answer: C

Rationale: The correct answer is C: Ensuring access to healthcare for all Americans. The primary focus of the Patient Protection and Affordable Care Act is to expand coverage, improve quality of care, and make healthcare more affordable and accessible to a greater number of people in the United States. Choice A is incorrect because while the act aims to make healthcare more affordable, its primary focus is on access. Choice B is incorrect as the act is not specifically designed to provide healthcare to undocumented immigrants. Choice D is incorrect as the act does not aim to eliminate the need for health insurance but rather improve the availability and affordability of insurance coverage.

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