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. 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.

3. The healthcare provider responds to an alarm on a pulse oximeter and sees that the patient's oxygen saturation is reading 38%. The provider observes the patient, noting a respiratory rate of 12 breaths per minute, pink mucous membranes, and easy regular respirations. The healthcare provider concludes that the pulse oximeter is not reading accurately. Whose theory of healthcare is this provider demonstrating?

• A. Annie Goodrich
• B. Lillian D. Wald
• C. Florence Nightingale
• D. Linda Richards

Correct answer: C

Rationale: Florence Nightingale emphasized the importance of assessing the patient's overall condition and not solely relying on technological readings. In this scenario, the healthcare provider's observation of the patient's respiratory rate, mucous membranes, and breathing pattern aligns with Nightingale's holistic approach to patient care. Annie Goodrich is known for her contributions to nursing education; Lillian D. Wald is associated with public health nursing and social reform; Linda Richards is recognized as America's first trained nurse. However, in this context, the emphasis is on the holistic patient assessment, which is a key principle of Florence Nightingale's theory.

4. 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.

5. A healthcare professional is reviewing the plan of care for a client following a total hip arthroplasty. Which of the following procedural plans is the healthcare professional following?

• A. patient classification categories
• B. diagnostic related groups
• C. Care map / clinical practice guideline
• D. functional nursing

Correct answer: C

Rationale: A care map or clinical practice guideline is a standardized plan of care that outlines the recommended interventions and treatments for patients with a specific condition. In this scenario, following a total hip arthroplasty, healthcare professionals typically refer to a care map or clinical practice guideline to ensure the patient receives appropriate care based on evidence-based practices and standards. Choices A, B, and D are incorrect in this context. Patient classification categories refer to grouping patients based on care needs, diagnostic related groups are used for billing purposes, and functional nursing is a care delivery system that assigns specific tasks to nursing personnel.

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