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 the new graduate nurse shares a journal article about caring with peers, a more experienced nurse says, 'You’d be a lot better off studying pathophysiology instead of wasting time on caring.' How does the graduate interpret the experienced nurse’s comment?

• A. The experienced nurse is just mean and doesn’t like new graduates.
• B. The experienced nurse is most likely overworked and cranky.
• C. The experienced nurse was educated in the medical model.
• D. The experienced nurse is uncaring and dislikes new graduates.

Correct answer: C

Rationale: The experienced nurse's comment likely reflects their education in the medical model, which emphasizes technical skills over caring. This suggests a difference in educational background rather than personal animosity towards new graduates. Choice A is incorrect as it assumes personal dislike without considering educational differences. Choice B is incorrect as it attributes the behavior to being overworked and cranky, which is not supported by the information given. Choice D is incorrect as it makes a broad assumption about the experienced nurse's character without considering the context of their comment.

3. A client with a terminal illness is concerned about performing self-care after discharge. Which of the following statements should the nurse make?

• A. A social worker will address your concerns after discharge.
• B. You should plan to go to a skilled nursing facility after discharge.
• C. Your case manager will coordinate the resources you will need.
• D. You will need hospice care until you feel stronger.

Correct answer: C

Rationale: In this scenario, the most appropriate statement for the nurse to make is that the case manager will coordinate the resources needed for self-care after discharge. Case managers are responsible for organizing and ensuring the provision of necessary resources and services to support the patient's care plan, making this the best option among the choices provided. Social workers typically address psychosocial concerns, skilled nursing facilities are for more intensive care needs, and hospice care is usually for end-of-life care, making them less suitable responses in this context.

4. 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.

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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