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. What term is used to identify a situation where a specific target and method of attack are identified by a reliable source, such as a bomb in the possession of a known terrorist group targeting a government building in a local community?

• A. Credible threat
• B. Biological event
• C. National disaster
• D. All-hazards approach

Correct answer: A

Rationale: A credible threat is the correct term used to identify a situation where a reliable source specifies both the target and method of attack, such as a bomb possessed by a known terrorist group targeting a government building in a local community. This term signifies a serious and imminent danger substantiated by credible information. Choice B, 'Biological event,' is incorrect as it refers to a different type of threat involving pathogens or biological agents. Choice C, 'National disaster,' is also incorrect as it pertains to large-scale events causing significant harm to a country or region, not a specific targeted attack. Choice D, 'All-hazards approach,' is not the term used to describe a specific identified threat; instead, it refers to a comprehensive strategy that addresses all types of hazards and risks in emergency management.

3. Medicaid, which is financed by what part of the government, is jointly funded by which two entities?

• A. State
• B. Federal
• C. County
• D. State and federal

Correct answer: D

Rationale: Medicaid is a healthcare program jointly funded by the state and federal governments. States have flexibility in administering Medicaid while adhering to federal guidelines, and both entities contribute funding to support the program. Choice A (State) is incorrect as Medicaid is not solely funded by the state government. Choice B (Federal) is not the only funding source for Medicaid. Choice C (County) is not a primary entity involved in financing Medicaid, making it incorrect. The correct answer is D, as Medicaid receives funding from both the state and federal governments.

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. When a nurse reads a peer-reviewed nursing journal article recommending a change in caring for a patient with an indwelling urinary catheter, which action demonstrates critical thinking?

• A. Implementing the article's recommendations in caring for a patient with an indwelling urinary catheter
• B. Presenting the journal article to the nurse manager and proposing a revision of the procedure
• C. Seeking additional peer-reviewed articles that corroborate the author's recommendation
• D. Disregarding the article and adhering to the facility's existing procedure

Correct answer: C

Rationale: Critical thinking involves evaluating information from various sources. In this scenario, the nurse displays critical thinking by seeking additional peer-reviewed articles that support the author's recommendation. This action ensures that decisions are based on a comprehensive understanding of the topic rather than relying solely on one source. By exploring other peer-reviewed articles, the nurse can validate the proposed change and make informed decisions regarding patient care. Choice A, implementing the article's recommendations, may not encompass a thorough evaluation of the information presented. Choice B, presenting the article to the nurse manager, is a valid step but does not directly involve critical analysis of the information. Choice D, disregarding the article, goes against the essence of critical thinking, which emphasizes the evaluation and consideration of various perspectives.

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