Nursing Elites

1. 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.

2. The nurse overhears a physician yelling at a newly hired graduate nurse in the hall. What is the nurse's best caring response?

• A. Yell at the physician for yelling at a new graduate and report the incident to the supervisor.
• B. Wait until the situation ends and comfort the graduate privately.
• C. Suggest that the physician take a quieter and more private approach to the problem.
• D. Ignore the situation to avoid embarrassing the graduate further.

Correct answer: C

Rationale: Suggesting a quieter and more private approach to the problem is the best caring response as it addresses the issue respectfully. This response shows empathy towards the graduate nurse and also aims to improve the situation without escalating it further. Choice A is not ideal as responding to yelling with yelling can exacerbate the situation and create more tension. Choice B, while offering comfort, does not directly address the inappropriate behavior of the physician. Choice D is not recommended as ignoring the situation may not help the graduate nurse and can lead to the continuation of inappropriate behavior without intervention.

3. The increasing use of licensed practical nurses (LPNs) in management positions, especially in long-term care facilities, is an example of what?

• A. Assertive management
• B. A shifting paradigm
• C. Critical thinking
• D. Smarter LPN graduates

Correct answer: B

Rationale: The correct answer is B: A shifting paradigm. The increasing use of LPNs in management positions, particularly in long-term care facilities, represents a changing paradigm in healthcare management. This shift indicates a move towards assigning leadership responsibilities to LPNs, signaling a departure from traditional industry roles. Choices A, C, and D are incorrect because the situation described does not primarily demonstrate assertive management, critical thinking, or the intelligence of LPN graduates. The focus is on the evolving role of LPNs in management, suggesting a broader change in healthcare practices.

4. Why is it important for healthcare professionals to have an understanding of healthcare issues in the United States?

• A. To ensure proper documentation of patient insurance information.
• B. Reimbursement policies often dictate the services that can be offered to the public.
• C. The quality of care provided is influenced by the patient's insurance coverage.
• D. Proficiency in healthcare issues is essential for graduating as a practical nurse.

Correct answer: B

Rationale: Understanding healthcare issues in the United States is crucial for healthcare professionals because reimbursement policies play a significant role in determining the services that can be provided to patients. By comprehending these issues, healthcare professionals can navigate the complexities of healthcare delivery, ensure appropriate services are offered, and optimize patient care outcomes. Choice A is incorrect because understanding healthcare issues goes beyond just documentation of patient insurance information. Choice C is incorrect as the quality of care should not be solely dependent on a patient's insurance coverage. Choice D is incorrect because while proficiency in healthcare issues is important for practical nurses, it is not a requirement solely for graduating.

5. 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.

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