Nursing Elites

1. 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.

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. During preoperative teaching for a client scheduled for a total knee arthroplasty who speaks a different language than the nurse, which interprofessional team member should the nurse include in the discussion?

• A. Interpreter
• B. Social worker
• C. Occupational therapist
• D. Spiritual advisor

Correct answer: A

Rationale: In this scenario, the nurse should include an interpreter in the discussion to facilitate clear and accurate communication between the nurse and the client who speaks a different language. The interpreter plays a crucial role in ensuring that the client fully understands the preoperative teaching and can express any concerns or questions effectively. Choice B, a social worker, is not the most appropriate option in this context as the primary need is language interpretation rather than social support. Choice C, an occupational therapist, is also not the best option as their role does not directly address the language barrier issue. Choice D, a spiritual advisor, is not relevant to the situation at hand and would not assist in overcoming the language barrier.

4. While working in a long-term care facility, the nurse notices that older residents take pleasure in telling stories about their earlier lives and reliving special events. The nurse recognizes this helps residents meet which level of Maslow's Hierarchy of needs?

• A. Self-esteem
• B. Love and belonging
• C. Safety
• D. Self-actualization

Correct answer: D

Rationale: The act of telling stories and reliving special events by the older residents in the long-term care facility helps them achieve self-actualization. Self-actualization involves realizing personal potential, self-fulfillment, seeking personal growth, and reflecting on their lives and achievements, which aligns with the behavior observed by the nurse. Choices A, B, and C are incorrect because self-esteem is related to confidence and respect, love and belonging refer to social relationships and connections, and safety pertains to physical and psychological security, which are not directly addressed by the residents' behavior of storytelling and reliving special events.

5. To form a core support group of nurses, where should the nurse organizer conduct meetings to gather initial information?

• A. Away from the work site with a group of managers to learn both sides of the situation
• B. In homes or local businesses with staff nurses
• C. At the facility to discuss nursing concerns
• D. At the work site with staff nurses who are respected leaders

Correct answer: B

Rationale: The correct approach is to conduct meetings in homes or local businesses with staff nurses. This location ensures confidentiality, prevents management influence, and allows the focus to be on gathering support for forming a core support group. Choice A is incorrect as involving managers may compromise the independence and authenticity of the group. Choice C is incorrect as conducting meetings at the facility may not provide a secure and unbiased environment for open discussions. Choice D is incorrect because holding meetings at the work site with respected leaders may lead to biased opinions and hinder open communication.

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