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 does the high degree of professionalism among nurses impact their willingness to engage in organized strikes?

• A. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession
• B. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization
• C. Nurses who strike can be legally punished for abandonment and negligence considered to be professional misconduct
• D. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client's safety initiatives

Correct answer: A

Rationale: The correct answer is A. The high level of professionalism among nurses, as recognized in Gallup polls, often leads them to perceive organized strikes as conflicting with their duty to care for patients and uphold their professional standards. This conflict of interest can cause nurses to be hesitant or reluctant to participate in strikes. Choice B is incorrect because nurses' decision to engage in strikes is more influenced by professional values and patient care rather than evidence-based studies on management and labor views. Choice C is incorrect because while legal consequences may be a concern, the primary factor influencing nurses' decision on strikes is their professional commitment to patient care. Choice D is incorrect as nurses' focus during strikes is more on advocating for patient safety rather than emphasizing safety initiatives.

3. How does the nurse apply Maslow's hierarchy of needs in care?

• A. Judging the patient's behavior
• B. Improving the skillfulness of care
• C. Understanding the patient's behavior
• D. Improving communication skills

Correct answer: C

Rationale: Maslow's hierarchy of needs is a framework that helps nurses understand the different levels of human needs and prioritize care accordingly. By applying this framework, nurses can better understand the patient's behavior in the context of their unmet needs. This understanding allows nurses to provide holistic and patient-centered care that addresses not just the physical but also the emotional, social, and psychological needs of the patient. Choice A is incorrect because applying Maslow's hierarchy is about understanding, not judging, the patient's behavior. Choice B is incorrect as it does not directly relate to the application of Maslow's hierarchy. Choice D is also incorrect as improving communication skills, although important, is not the primary focus when applying Maslow's hierarchy of needs in care.

4. The nurse is providing pre-operative teaching to the anxious patient, who doesn't seem to be learning. What need must the nurse help this patient meet before continuing to teach?

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

Correct answer: C

Rationale: The correct answer is C: Safety. Before effective learning can occur, the patient's safety needs must be addressed. When patients feel safe and secure, they are better able to focus on receiving and processing information. Ensuring the patient's safety is a fundamental step in providing care and support, especially in a pre-operative setting where anxiety and concerns about the procedure may be high. Choices A, B, and D are incorrect because while self-esteem, love and belonging, and self-actualization are important needs, the immediate priority in this scenario is addressing the patient's safety concerns to create a conducive environment for learning.

5. A healthcare professional is reviewing the plan of care for a client following a total hip arthroplasty. Which of the following procedural plans is the healthcare professional following?

• A. patient classification categories
• B. diagnostic related groups
• C. Care map / clinical practice guideline
• D. functional nursing

Correct answer: C

Rationale: A care map or clinical practice guideline is a standardized plan of care that outlines the recommended interventions and treatments for patients with a specific condition. In this scenario, following a total hip arthroplasty, healthcare professionals typically refer to a care map or clinical practice guideline to ensure the patient receives appropriate care based on evidence-based practices and standards. Choices A, B, and D are incorrect in this context. Patient classification categories refer to grouping patients based on care needs, diagnostic related groups are used for billing purposes, and functional nursing is a care delivery system that assigns specific tasks to nursing personnel.

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