Nursing Elites

1. 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.

2. When demonstrating therapeutic use of self, which nursing intervention is the nurse performing?

• A. Sitting with a dying patient
• B. Attending class
• C. Studying for a test
• D. Learning the nursing code of ethics

Correct answer: A

Rationale: The correct answer is A: Sitting with a dying patient. Therapeutic use of self in nursing involves the nurse's ability to establish a caring and compassionate relationship with patients. Sitting with a dying patient allows the nurse to provide emotional support, physical presence, and comfort, demonstrating the use of self in a therapeutic manner. Choices B, C, and D are incorrect as they do not directly involve the nurse's interaction with a patient in a therapeutic manner.

3. Which patient would be appropriately transferred to an assisted living facility?

• A. The patient requiring ongoing skilled nursing observation
• B. The patient who has recovered enough to return to work and daily life
• C. The child who was burned in a fire after losing both parents to the tragedy
• D. The patient who needs minimal assistance in performing activities of daily living but cannot live alone

Correct answer: D

Rationale: The correct answer is D. Patients suitable for transfer to assisted living facilities are those who require minimal assistance with activities of daily living but do not need constant skilled nursing observation. Option D aligns with the purpose of an assisted living facility, which provides support for individuals who can no longer live independently but do not require intensive medical care. Choices A, B, and C are incorrect because patients requiring ongoing skilled nursing observation, those who have recovered enough to return to work and daily life, and children who have experienced a traumatic event such as a fire are not typically candidates for assisted living facilities.

4. While working in a long-term care facility, the nurse notices that older residents take pleasure in telling stories about their earlier lives and reliving special events. The nurse recognizes this helps residents meet which level of Maslow's Hierarchy of needs?

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

Correct answer: D

Rationale: The act of telling stories and reliving special events by the older residents in the long-term care facility helps them achieve self-actualization. Self-actualization involves realizing personal potential, self-fulfillment, seeking personal growth, and reflecting on their lives and achievements, which aligns with the behavior observed by the nurse. Choices A, B, and C are incorrect because self-esteem is related to confidence and respect, love and belonging refer to social relationships and connections, and safety pertains to physical and psychological security, which are not directly addressed by the residents' behavior of storytelling and reliving special events.

5. The healthcare provider responds to an alarm on a pulse oximeter and sees that the patient's oxygen saturation is reading 38%. The provider observes the patient, noting a respiratory rate of 12 breaths per minute, pink mucous membranes, and easy regular respirations. The healthcare provider concludes that the pulse oximeter is not reading accurately. Whose theory of healthcare is this provider demonstrating?

• A. Annie Goodrich
• B. Lillian D. Wald
• C. Florence Nightingale
• D. Linda Richards

Correct answer: C

Rationale: Florence Nightingale emphasized the importance of assessing the patient's overall condition and not solely relying on technological readings. In this scenario, the healthcare provider's observation of the patient's respiratory rate, mucous membranes, and breathing pattern aligns with Nightingale's holistic approach to patient care. Annie Goodrich is known for her contributions to nursing education; Lillian D. Wald is associated with public health nursing and social reform; Linda Richards is recognized as America's first trained nurse. However, in this context, the emphasis is on the holistic patient assessment, which is a key principle of Florence Nightingale's theory.

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