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. While supervising the care of several clients, which action requires intervention by the charge nurse?

• A. A nurse photocopies a client's diagnostic test results.
• B. An assistive personnel documents the client's vital signs on the client's paper-based graphic record.
• C. The unit secretary faxes a client's laboratory results to the provider.
• D. An RN stays with a client to discuss her understanding of her vital signs that were requested.

Correct answer: A

Rationale: The charge nurse should intervene when a nurse photocopies a client's diagnostic test results as it violates patient confidentiality and privacy. This action breaches HIPAA regulations, and sensitive patient information should not be photocopied without proper authorization. The other actions are within the scope of practice and do not raise concerns regarding patient privacy or confidentiality.

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. 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.

5. What term is used to identify a situation where a specific target and method of attack are identified by a reliable source, such as a bomb in the possession of a known terrorist group targeting a government building in a local community?

• A. Credible threat
• B. Biological event
• C. National disaster
• D. All-hazards approach

Correct answer: A

Rationale: A credible threat is the correct term used to identify a situation where a reliable source specifies both the target and method of attack, such as a bomb possessed by a known terrorist group targeting a government building in a local community. This term signifies a serious and imminent danger substantiated by credible information. Choice B, 'Biological event,' is incorrect as it refers to a different type of threat involving pathogens or biological agents. Choice C, 'National disaster,' is also incorrect as it pertains to large-scale events causing significant harm to a country or region, not a specific targeted attack. Choice D, 'All-hazards approach,' is not the term used to describe a specific identified threat; instead, it refers to a comprehensive strategy that addresses all types of hazards and risks in emergency management.

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