Nursing Elites

1. 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.

2. 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.

3. 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.

4. Medicaid, which is financed by what part of the government, is jointly funded by which two entities?

• A. State
• B. Federal
• C. County
• D. State and federal

Correct answer: D

Rationale: Medicaid is a healthcare program jointly funded by the state and federal governments. States have flexibility in administering Medicaid while adhering to federal guidelines, and both entities contribute funding to support the program. Choice A (State) is incorrect as Medicaid is not solely funded by the state government. Choice B (Federal) is not the only funding source for Medicaid. Choice C (County) is not a primary entity involved in financing Medicaid, making it incorrect. The correct answer is D, as Medicaid receives funding from both the state and federal governments.

5. A client with a terminal illness is concerned about performing self-care after discharge. Which of the following statements should the nurse make?

• A. A social worker will address your concerns after discharge.
• B. You should plan to go to a skilled nursing facility after discharge.
• C. Your case manager will coordinate the resources you will need.
• D. You will need hospice care until you feel stronger.

Correct answer: C

Rationale: In this scenario, the most appropriate statement for the nurse to make is that the case manager will coordinate the resources needed for self-care after discharge. Case managers are responsible for organizing and ensuring the provision of necessary resources and services to support the patient's care plan, making this the best option among the choices provided. Social workers typically address psychosocial concerns, skilled nursing facilities are for more intensive care needs, and hospice care is usually for end-of-life care, making them less suitable responses in this context.

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