Nursing Elites

1. Which patient would be appropriately transferred to an assisted living facility?

• A. The patient requiring ongoing skilled nursing observation
• B. The patient who has recovered enough to return to work and daily life
• C. The child who was burned in a fire after losing both parents to the tragedy
• D. The patient who needs minimal assistance in performing activities of daily living but cannot live alone

Correct answer: D

Rationale: The correct answer is D. Patients suitable for transfer to assisted living facilities are those who require minimal assistance with activities of daily living but do not need constant skilled nursing observation. Option D aligns with the purpose of an assisted living facility, which provides support for individuals who can no longer live independently but do not require intensive medical care. Choices A, B, and C are incorrect because patients requiring ongoing skilled nursing observation, those who have recovered enough to return to work and daily life, and children who have experienced a traumatic event such as a fire are not typically candidates for assisted living facilities.

2. 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.

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. 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.

5. 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.

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