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 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.

3. On what basis does the U.S. healthcare system operate?

• A. Healthcare is a basic right provided to all equally.
• B. Ability to pay determines access to care.
• C. Only the rich are entitled to healthcare.
• D. Health insurance is required to obtain care.

Correct answer: B

Rationale: The correct answer is B. In the U.S., the healthcare system operates on a model where access to healthcare services is largely determined by an individual's ability to pay for care. This means that those with more financial resources have greater access to a wider range of healthcare services, while those with limited financial means may face barriers to accessing necessary care. Choices A, C, and D are incorrect because healthcare in the U.S. is not universally provided as a basic right to all equally, it is not exclusively for the rich, and while health insurance is common, it is not the sole determinant of access to care.

4. 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.

5. What term is used to identify the care delivery model being used when a nurse makes patient care assignments as follows: RN1 has rooms 202-210, RN2 has rooms 211-221, RN3 has rooms 222-232. The unlicensed assistive personnel have half the rooms, with one assigned to 202-215 and the second to 216-232?

• A. Partnership
• B. Primary
• C. Modular
• D. Team

Correct answer: C

Rationale: The term used to identify the care delivery model being used in this scenario is 'Modular.' In modular nursing, a nursing unit is divided into modules, with each module staffed by a team assigned to specific rooms. This division allows for a more organized and efficient delivery of care, with clear assignments and responsibilities for each team. Choices A, B, and D are incorrect. Partnership typically refers to collaboration between healthcare providers; Primary is related to the patient's main healthcare provider; and Team is a general term that does not specifically describe the modular care delivery model outlined in the question.

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