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. According to Watson's theory, how should the nurse manager deal with a staff member who has a substance addiction and is arriving at work under the influence of the substance?

• A. Send the nurse home with instructions not to return until clear of the substance.
• B. Call the police and have the nurse arrested for working while impaired.
• C. Confront the nurse privately, order drug testing, and suggest a substance abuse program.
• D. Notify the board of nursing and fire the nurse immediately.

Correct answer: C

Rationale: According to Watson's theory, a caring approach is essential. Confronting the nurse privately, ordering drug testing, and suggesting a substance abuse program demonstrates empathy and supports the staff member in seeking help for their addiction. This approach aligns with the principles of human caring and compassion, focusing on the well-being and recovery of the individual rather than punitive measures. Choices A and D are too harsh and lack empathy, not considering the individual's well-being or offering support for rehabilitation. Choice B is inappropriate and punitive, not aligned with a caring and compassionate approach as advocated by Watson's theory.

3. How can a student best prepare for a clinical experience?

• A. Practice and review procedures for performing skills
• B. Review class notes from the past week
• C. Familiarize oneself with the clinical facility
• D. Arrive at the clinical site 1 hour early

Correct answer: A

Rationale: Practicing and reviewing procedures for performing skills is crucial for a student preparing for a clinical experience. This preparation allows the student to build competence and confidence in executing required tasks. Reviewing class notes may be helpful for theoretical knowledge but may not adequately prepare the student for practical skills needed in a clinical setting. Familiarizing oneself with the clinical facility is beneficial but does not directly address skill readiness. Arriving early is important but does not substitute for the essential preparation of practicing and reviewing procedures for performing skills.

4. In a system of care delivery in which RNs, LPNs, and unlicensed assistive personnel implement specific tasks like medication administration or personal hygiene for the entire nursing unit, what term describes this type of delivery system?

• A. Primary nursing
• B. Team nursing
• C. Functional nursing
• D. Total patient care

Correct answer: C

Rationale: Functional nursing is a care delivery model where tasks are divided among team members based on their respective roles. In this system, RNs, LPNs, and unlicensed assistive personnel are assigned specific tasks to carry out for the entire nursing unit, such as medication administration or personal hygiene duties. The other choices are incorrect: A) Primary nursing involves one nurse being responsible for all aspects of care for a group of patients, B) Team nursing involves a team of healthcare providers working together to provide care for a group of patients, and D) Total patient care refers to one nurse being responsible for all aspects of care for one patient.

5. 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.

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