Nursing Elites

1. Nurses and community officials are working together to ensure that churches and schools have needed supplies to provide shelter for a large number of individuals in the event of a natural or man-made disaster. These activities represent which phase of a disaster continuum?

• A. Crisis Intervention
• B. Preparedness
• C. Recovery
• D. Relief Response

Correct answer: B

Rationale: The scenario described in the question, where nurses and community officials are preparing churches and schools with supplies for potential disaster situations, falls under the Preparedness phase of a disaster continuum. Preparedness involves planning, organizing, and equipping to handle potential disasters before they occur. This phase aims to enhance the readiness of individuals, organizations, and systems to respond effectively when a disaster strikes. Choices A, C, and D are incorrect because they do not align with the activities of preparing for a disaster before it happens; Crisis Intervention deals with immediate response during or after a disaster, Recovery focuses on rebuilding and restoring after a disaster, and Relief Response involves providing immediate assistance in the aftermath of a disaster.

2. 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.

3. 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.

4. The nurse is caring for a patient transferred from the local prison who was arrested and convicted of child sexual abuse. The nurse feels disgust for the patient's behavior but can avoid being judgmental by understanding what?

• A. Motivation
• B. State laws
• C. The patient's social history
• D. Code of ethics

Correct answer: A

Rationale: In this scenario, the nurse is experiencing negative emotions towards the patient's behavior. By understanding the patient's motivation, the nurse can gain insight into the underlying factors that led to the behavior, helping to avoid being judgmental. This approach allows the nurse to provide care and support without letting personal feelings interfere. Understanding motivation can also aid in developing a therapeutic relationship and providing appropriate care tailored to the patient's needs. Choices B, C, and D are incorrect as while state laws, the patient's social history, and the code of ethics are important aspects to consider in healthcare, they do not directly address the nurse's feelings of disgust and the need to avoid being judgmental towards the patient's behavior.

5. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

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