Nursing Elites

1. While working in the clinical facility, the student nurse learns that a family member has been admitted to the same facility. What statement is true about the student's access to the family member's medical record?

• A. The student may access the family member's medical record as a nurse in the facility.
• B. The student nurse should not access the family member's record until obtaining instructor approval.
• C. The student may access the family member's medical record because of the family relationship.
• D. The student nurse should not view the record unless they are providing care for the family member.

Correct answer: D

Rationale: The student nurse should not view the family member's record unless they are directly involved in providing care to maintain confidentiality. Accessing the record without a legitimate reason breaches patient confidentiality and violates ethical principles. Choice A is incorrect because being a nurse in the facility does not automatically grant access to a family member's record. Choice B is incorrect as it does not address the primary concern of direct involvement in care. Choice C is incorrect as family relationship alone does not justify accessing the medical record.

2. On what are most nursing paradigms based?

• A. The nurse's ability to perform procedures with skill
• B. Dr. Jean Watson's transpersonal caring theory
• C. Maslow's theory of hierarchy of needs
• D. Learning by studying nursing theories and clinical experiences

Correct answer: D

Rationale: Most nursing paradigms are founded on the understanding and application of nursing theories through studying them and gaining practical experiences in clinical settings. While the nurse's ability to perform procedures with skill is important, it is not the foundation of nursing paradigms. Dr. Jean Watson's transpersonal caring theory and Maslow's theory of hierarchy of needs are significant in nursing practice but do not serve as the basis for most nursing paradigms. Nursing paradigms are shaped by a combination of studying nursing theories and hands-on clinical experiences, which provide the foundational knowledge and practical skills needed for nursing practice.

3. On what basis does the U.S. healthcare system operate?

• A. Healthcare is a basic right provided to all equally.
• B. Ability to pay determines access to care.
• C. Only the rich are entitled to healthcare.
• D. Health insurance is required to obtain care.

Correct answer: B

Rationale: The correct answer is B. In the U.S., the healthcare system operates on a model where access to healthcare services is largely determined by an individual's ability to pay for care. This means that those with more financial resources have greater access to a wider range of healthcare services, while those with limited financial means may face barriers to accessing necessary care. Choices A, C, and D are incorrect because healthcare in the U.S. is not universally provided as a basic right to all equally, it is not exclusively for the rich, and while health insurance is common, it is not the sole determinant of access to care.

4. 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.

5. What is a major source of stress on the current U.S. healthcare system?

• A. Rising cost of providing healthcare to all citizens
• B. Lack of adequate education for healthcare professionals
• C. Inadequate number of hospital beds across the country
• D. Increasing cost of malpractice insurance

Correct answer: A

Rationale: The increasing cost of providing healthcare to all citizens is a major source of stress on the current U.S. healthcare system. This rise in costs impacts various aspects of the system, including accessibility, quality of care, and financial sustainability. It affects healthcare providers, patients, insurance companies, and the government, making it a critical issue that needs to be addressed to ensure a more efficient and effective healthcare system. Choices B, C, and D are incorrect because although lack of education for healthcare professionals, inadequate number of hospital beds, and increasing malpractice insurance costs can be challenges within the healthcare system, they are not the primary source of stress that affects the system as a whole.

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