Nursing Elites

1. The patient tells the nurse that his insurance company requires him to pick a primary provider and asks what that means. The nurse explains that a primary provider means choosing what?

• A. A doctor
• B. A staff nurse
• C. One insurance provider
• D. A hospital

Correct answer: A

Rationale: A primary provider is typically a doctor, nurse practitioner, or physician's assistant who is responsible for overseeing and coordinating the patient's comprehensive healthcare needs. This healthcare professional serves as the main point of contact for the patient, managing preventive care, treatments, referrals to specialists, and overall health management. Choice B, a staff nurse, is incorrect as a primary provider is usually a more advanced healthcare professional managing comprehensive care. Choice C, one insurance provider, is incorrect as a primary provider refers to a healthcare professional, not an insurance company. Choice D, a hospital, is incorrect as the primary provider is an individual healthcare professional responsible for coordinating the patient's care, not a healthcare facility.

2. 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.

3. 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.

4. What factor has had the greatest impact on the current nursing shortage?

• A. Later age at which women have children
• B. Decrease in the number of women being born
• C. Overall unemployment rate
• D. Increased employment options for women

Correct answer: D

Rationale: The correct answer is D. The increased employment options for women have had a significant impact on the current nursing shortage. With more career choices available to women, there is a decrease in the number of individuals pursuing nursing as a profession, contributing to the shortage. This is because women are choosing diverse career paths due to increased opportunities. Choices A, B, and C are incorrect. A later age at which women have children and the decrease in the number of women being born are not directly related to the nursing shortage. The overall unemployment rate, while influencing job availability, is not the primary factor driving the shortage of nurses.

5. Which title identifies a nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers?

• A. Team leader in nursing care delivery
• B. Case manager
• C. Nurse manager
• D. Coordinator of patient-centered care delivery

Correct answer: B

Rationale: The correct answer is B: Case manager. A case manager plays a crucial role in coordinating a patient's care across different healthcare settings and providers to ensure continuity, efficiency, and optimal outcomes. They work closely with various members of the healthcare team to facilitate a comprehensive care plan and address the patient's needs throughout their healthcare journey. Choice A is incorrect because a team leader in nursing care delivery focuses more on supervising a team of nurses rather than patient care coordination. Choice C, Nurse manager, typically oversees a nursing unit or department but may not have the primary role of coordinating a patient's care. Choice D, Coordinator of patient-centered care delivery, though related, does not specify the direct responsibility of following a patient from admission to discharge or resolution of illness.

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