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. The educator is teaching a group about paradigm thinking and defines it as what?

• A. One's mathematical knowledge and ability to solve math problems
• B. The ability to see 20 feet away without wearing glasses
• C. An individual's perception or frame of reference about the world
• D. A healthcare provider's ability to solve patient-care problems

Correct answer: C

Rationale: Paradigm thinking refers to an individual's perception or frame of reference about the world. It involves understanding how one sees and interprets the world around them, which can influence their beliefs, decisions, and actions. Choices A, B, and D are incorrect as they do not accurately describe paradigm thinking. Paradigm thinking is not solely related to mathematical knowledge, eyesight, or healthcare problem-solving skills.

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. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

5. The healthcare provider is caring for an adolescent who will be hospitalized for several weeks while in traction. The patient frequently has a room full of friends, and they can be heard laughing. The healthcare provider recognizes this patient is meeting which of Maslow's hierarchy of needs?

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

Correct answer: B

Rationale: Love and belonging needs, as per Maslow's hierarchy, refer to the sense of belonging, being accepted, and forming meaningful relationships. In this scenario, the patient having friends around and engaging in social interactions indicates fulfillment of the love and belonging need. Choice A, self-esteem, focuses on self-respect and confidence, which are not directly related to the patient's interaction with friends. Choice C, safety, involves physical and psychological safety, which may be important but not the primary need being met in this situation. Choice D, self-actualization, relates to realizing personal potential, creativity, and achieving goals, which are at a higher level in the hierarchy compared to the need for love and belonging.

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