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 considering factors like high risk for falls, infection protocols, and special communication needs to determine the mix and number of staff needed on a telemetry unit, what is being utilized?

• A. diagnostic related groups
• B. clinical pathways
• C. case management
• D. Patient classification system

Correct answer: D

Rationale: In this scenario, the nurse is using a Patient Classification System, which helps in determining the appropriate staffing levels based on the acuity and care requirements of the patients in the telemetry unit. By considering factors like high risk for falls, infection protocols, and special communication needs, the nurse can allocate the right mix and number of staff to provide safe and effective care. The other choices are incorrect because diagnostic related groups are used for billing purposes, clinical pathways are standard care plans for specific diagnoses, and case management involves coordinating care and services for patients.

3. What is a crucial issue a healthcare worker in the late industrialization era would need to address to promote health?

• A. Reducing the spread of infection
• B. Promoting physical activity
• C. Educating on medication administration
• D. Promoting child safety in transportation

Correct answer: A

Rationale: During the late industrialization era, communicable diseases were rampant due to poor sanitation and lack of infection control measures. Healthcare workers, including nurses, played a critical role in reducing the spread of infections to prevent disease transmission and improve public health. This focus on infection control was crucial to address the prevalent health issues of the time. Choices B, C, and D, while important in healthcare, were not as pressing during the late industrialization era compared to the urgent need to control the spread of infections.

4. 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.

5. 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.

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