Nursing Elites

1. 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.

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. The healthcare provider is caring for an adolescent who will be hospitalized for several weeks while in traction. The patient frequently has a room full of friends, and they can be heard laughing. The healthcare provider recognizes this patient is meeting which of Maslow's hierarchy of needs?

• A. Self-esteem
• B. Love and belonging
• C. Safety
• D. Self-actualization

Correct answer: B

Rationale: Love and belonging needs, as per Maslow's hierarchy, refer to the sense of belonging, being accepted, and forming meaningful relationships. In this scenario, the patient having friends around and engaging in social interactions indicates fulfillment of the love and belonging need. Choice A, self-esteem, focuses on self-respect and confidence, which are not directly related to the patient's interaction with friends. Choice C, safety, involves physical and psychological safety, which may be important but not the primary need being met in this situation. Choice D, self-actualization, relates to realizing personal potential, creativity, and achieving goals, which are at a higher level in the hierarchy compared to the need for love and belonging.

4. What factor has had the greatest impact on the current nursing shortage?

• A. Later age at which women have children
• B. Decrease in the number of women being born
• C. Overall unemployment rate
• D. Increased employment options for women

Correct answer: D

Rationale: The correct answer is D. The increased employment options for women have had a significant impact on the current nursing shortage. With more career choices available to women, there is a decrease in the number of individuals pursuing nursing as a profession, contributing to the shortage. This is because women are choosing diverse career paths due to increased opportunities. Choices A, B, and C are incorrect. A later age at which women have children and the decrease in the number of women being born are not directly related to the nursing shortage. The overall unemployment rate, while influencing job availability, is not the primary factor driving the shortage of nurses.

5. Which historical figure is honored for working to improve care of the mentally ill in mental health nursing?

• 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. Dix played a crucial role in establishing mental health institutions and reforming the care provided to individuals with mental health conditions. Clara Barton is known for founding the American Red Cross, Florence Nightingale is renowned as the founder of modern nursing, and Lillian D. Wald is recognized for her work in public health nursing. However, none of them are specifically honored for their work in improving care for the mentally ill in mental health nursing, unlike Dorothea Dix.

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