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. When the new graduate nurse shares a journal article about caring with peers, a more experienced nurse says, 'You’d be a lot better off studying pathophysiology instead of wasting time on caring.' How does the graduate interpret the experienced nurse’s comment?

• A. The experienced nurse is just mean and doesn’t like new graduates.
• B. The experienced nurse is most likely overworked and cranky.
• C. The experienced nurse was educated in the medical model.
• D. The experienced nurse is uncaring and dislikes new graduates.

Correct answer: C

Rationale: The experienced nurse's comment likely reflects their education in the medical model, which emphasizes technical skills over caring. This suggests a difference in educational background rather than personal animosity towards new graduates. Choice A is incorrect as it assumes personal dislike without considering educational differences. Choice B is incorrect as it attributes the behavior to being overworked and cranky, which is not supported by the information given. Choice D is incorrect as it makes a broad assumption about the experienced nurse's character without considering the context of their comment.

3. A healthcare professional walks into the nurse's station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions should the healthcare professional take first?

• A. remind the staff members that this is a breach of confidentiality
• B. discuss the issue with the unit manager
• C. request that an administrative restriction be placed on the client's medical access
• D. prepare a report for the facility ethics committee

Correct answer: A

Rationale: The correct action for the healthcare professional to take first is to remind the staff members that accessing the electronic medical record of a celebrity client from another unit is a breach of confidentiality. This immediate action addresses the ethical and legal issue at hand, emphasizing the importance of patient confidentiality and privacy. Discussing the issue with the unit manager, requesting administrative restrictions, or preparing a report for the facility ethics committee can be considered after addressing the initial breach and reminding staff members of their obligations.

4. What is the difference between the LPN and LVN nursing titles?

• A. LPNs and LVNs have the same educational program length.
• B. LVNs and LPNs have the same duties and skills but hold different titles.
• C. LVNs are able to perform venipuncture, whereas LPNs cannot.
• D. LPNs can pursue an RN license, while LVNs are not on the same path.

Correct answer: B

Rationale: The correct answer is B. LVNs and LPNs have the same duties and skills but hold different titles. The distinction between the two titles is primarily regional, with some states using LPN (Licensed Practical Nurse) and others using LVN (Licensed Vocational Nurse) to refer to the same role. Their scope of practice, responsibilities, and educational requirements are essentially equivalent, with the only notable difference being the title itself. Choices A, C, and D are incorrect because LPNs and LVNs generally have similar educational program lengths, both can perform venipuncture, and both have the potential to pursue further education and licensure to become registered nurses (RNs) if they choose to do so.

5. How can a healthcare provider best address the spiritual aspect of caring for a patient?

• A. Explain the patient's spiritual beliefs to the healthcare provider.
• B. Ask the patient to share their spiritual beliefs.
• C. Ask what the patient requires to meet their spiritual needs.
• D. Consult with a spiritual leader to understand the patient's spiritual needs.

Correct answer: C

Rationale: The most effective way for a healthcare provider to address the spiritual aspect of caring for a patient is by asking what the patient requires to meet their spiritual needs. This approach respects the patient's autonomy, acknowledges their individual beliefs, and allows for personalized and patient-centered care. Choice A is incorrect as it focuses on the healthcare provider's understanding rather than the patient's needs. Choice B could be invasive and may not be necessary to provide adequate spiritual care. Choice D involves consulting a spiritual leader, which may not always align with the patient's personal beliefs and preferences.

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