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. 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.

3. 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.

4. The nurse listens as the physician asks the patient to participate in a research study and realizes the physician is not adequately explaining the risks of the study. As they leave the patient's room, the nurse encourages the physician to go back and explain the risks more thoroughly. What role is this nurse playing in patient care?

• A. Teacher
• B. Caregiver
• C. Advocate
• D. Communicator

Correct answer: C

Rationale: The nurse is acting as an advocate by ensuring the patient is fully informed before consenting to participate in the study. Advocacy in healthcare involves supporting and promoting the patient's rights, including the right to be fully informed about their care and treatment options. By advocating for the patient in this scenario, the nurse is prioritizing the patient's well-being and autonomy. Choices A, B, and D are incorrect. The nurse is not acting as a teacher, caregiver, or communicator specifically in this scenario, but rather advocating for the patient's right to informed consent.

5. The patient tells the nurse that his insurance company requires him to pick a primary provider and asks what that means. The nurse explains that a primary provider means choosing what?

• A. A doctor
• B. A staff nurse
• C. One insurance provider
• D. A hospital

Correct answer: A

Rationale: A primary provider is typically a doctor, nurse practitioner, or physician's assistant who is responsible for overseeing and coordinating the patient's comprehensive healthcare needs. This healthcare professional serves as the main point of contact for the patient, managing preventive care, treatments, referrals to specialists, and overall health management. Choice B, a staff nurse, is incorrect as a primary provider is usually a more advanced healthcare professional managing comprehensive care. Choice C, one insurance provider, is incorrect as a primary provider refers to a healthcare professional, not an insurance company. Choice D, a hospital, is incorrect as the primary provider is an individual healthcare professional responsible for coordinating the patient's care, not a healthcare facility.

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