Nursing Elites

1. Many patient classification systems have some type of shortcoming. Among these are:

• A. The client's condition changes before the next shift.
• B. The staffing needs are predicted on a short-term basis.
• C. The potential admissions cannot be accounted for.
• D. The staffing mix changes because of illness.

Correct answer: C

Rationale: Patient classification systems have limitations in accounting for changes in a client's condition, unexpected influx of new admissions, and changes in staffing due to illness. These systems often focus on short-term staffing needs rather than utilizing demand management, which considers client outcomes to predict staffing needs over a longer period. Not being able to account for potential admissions can lead to challenges in effectively managing staff allocation and resources. Choices A, B, and D are incorrect because they do not address the specific limitation of patient classification systems related to accounting for potential admissions.

2. What is the term for working on a schedule within the unit, involving only those who are working within that unit?

• A. Flexible staffing
• B. Self-staffing
• C. Internal pools
• D. Management scheduling

Correct answer: B

Rationale: The correct answer is B, self-staffing. Self-staffing is the model where staff entirely manage staffing and scheduling themselves, without external involvement. Choices A, C, and D are incorrect. Flexible staffing refers to adjusting staffing levels based on demand. Internal pools involve a group of staff who can be drawn upon for scheduling needs. Management scheduling typically involves supervisors or managers creating and managing schedules for the unit.

3. A registered nurse (RN) is caring for a patient who is one of Jehovah�s Witnesses and has refused a blood transfusion even though her hemoglobin is dangerously low. After providing information about all the alternatives available and risks and benefits of each, the health-care provider allows the patient to determine which course of treatment she would prefer. The RN knows this is an example of which ethical principle?

• A. Autonomy
• B. Nonmaleficence
• C. Beneficence
• D. Distributive justice

Correct answer: A

Rationale: This is an example of the ethical principle of autonomy.

4. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: A DNR order can be written after the health-care provider has discussed it with the client and family.

5. One way to determine staffing needs is to classify clients according to nursing care required. Another name for this is a(n) __________.

• A. self-scheduling
• B. supplementing staff system
• C. patient classification system (PCS)
• D. acuity system

Correct answer: D

Rationale: The correct answer is D: acuity system. An acuity system involves classifying clients based on the nursing care they require to determine staffing needs accurately. Choice A, self-scheduling, is not related to classifying clients based on care needs. Choice B, supplementing staff system, does not specifically refer to the classification of clients. Choice C, patient classification system (PCS), is close but not as commonly used as 'acuity system' in healthcare settings to determine staffing needs.

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