Nursing Elites

1. What is the primary goal of discharge planning?

• A. Reducing readmission rates
• B. Improving patient outcomes
• C. Ensuring continuity of care
• D. Ensuring medication adherence

Correct answer: C

Rationale: The primary goal of discharge planning is to ensure continuity of care for patients transitioning from one level of care to another. While reducing readmission rates and improving patient outcomes are important aspects of discharge planning, the main focus is on coordinating care to prevent gaps and ensure a seamless transition for the patient. Ensuring medication adherence is also crucial but falls under the broader goal of continuity of care.

2. A nurse manager who tells the staff to 'come to me with any problem' but then keeps the office door closed is using what type of communication?

• A. Intrasender conflict
• B. Diagonal communication
• C. Metacommunication
• D. Upward communication

Correct answer: A

Rationale: The correct answer is A: Intrasender conflict. Intrasender conflict happens when there is a discrepancy between verbal and nonverbal communication. In this scenario, the nurse manager's verbal message encourages staff to communicate openly, but the closed office door sends a conflicting nonverbal message, creating intrasender conflict. Metacommunication involves nonverbal behaviors like gestures or facial expressions that support or contradict verbal communication. Upward communication refers to the flow of information from staff to management or lower to upper management. Diagonal communication involves communication between individuals or departments at different hierarchical levels.

3. A nurse is considering employment at a long-term care facility that has a functional nursing delivery system. Knowing this, the nurse could expect that:

• A. Each RN would coordinate care for a group of clients.
• B. One RN would pass meds for all clients on a unit.
• C. Each RN would deliver total care to an assigned group of clients.
• D. One RN, one LPN, and one unlicensed assistive personnel would share responsibility for a group of clients.

Correct answer: B

Rationale: In a functional nursing delivery system, tasks are divided among the staff based on their roles. One of these roles is medication administration, where one RN may pass medications for all clients on a unit. Option A is incorrect because coordinating care for a group of clients is more aligned with team nursing. Option C is incorrect as it describes total care nursing, not functional nursing. Option D is incorrect as it reflects team nursing with a mix of different roles sharing responsibility.

4. A nurse is assessing a client's readiness to learn about insulin self-administration. Which of the following statements should the nurse identify as an indication that the client is ready to learn?

• A. "I can concentrate best in the morning."
• B. "It is difficult to read the instructions because my glasses are at home."
• C. "I'm wondering why I need to learn this."
• D. "You will have to talk to my partner about this."

Correct answer: D

Rationale: The correct answer is D, "You will have to talk to my partner about this." This response indicates that the client is willing to involve their partner in the learning process, showing readiness to take responsibility and engage in the education. Choices A, B, and C demonstrate potential barriers to learning: A indicates a preference for learning time but does not show active involvement, B focuses on external factors hindering learning, and C reflects a lack of understanding or motivation for the learning.

5. When a client who is in pain refuses to be repositioned, what should the nurse consider first in making a decision about what to do?

• A. Why a decision is needed.
• B. Who actually gets to make the decision?
• C. What are the alternatives?
• D. When a decision is needed.

Correct answer: A

Rationale: In this scenario, the nurse should first consider why a decision is needed. Understanding the underlying reason for the decision helps in selecting the best action to meet the desired goal. Who actually makes the decision is important but not the primary consideration. Exploring alternatives comes after determining the reason for the decision, who makes it, and when it is needed.

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