Nursing Elites

1. Which title identifies a nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers?

• A. Team leader in nursing care delivery
• B. Case manager
• C. Nurse manager
• D. Coordinator of patient-centered care delivery

Correct answer: B

Rationale: The correct answer is B: Case manager. A case manager plays a crucial role in coordinating a patient's care across different healthcare settings and providers to ensure continuity, efficiency, and optimal outcomes. They work closely with various members of the healthcare team to facilitate a comprehensive care plan and address the patient's needs throughout their healthcare journey. Choice A is incorrect because a team leader in nursing care delivery focuses more on supervising a team of nurses rather than patient care coordination. Choice C, Nurse manager, typically oversees a nursing unit or department but may not have the primary role of coordinating a patient's care. Choice D, Coordinator of patient-centered care delivery, though related, does not specify the direct responsibility of following a patient from admission to discharge or resolution of illness.

2. According to Watson's theory, how should the nurse manager deal with a staff member who has a substance addiction and is arriving at work under the influence of the substance?

• A. Send the nurse home with instructions not to return until clear of the substance.
• B. Call the police and have the nurse arrested for working while impaired.
• C. Confront the nurse privately, order drug testing, and suggest a substance abuse program.
• D. Notify the board of nursing and fire the nurse immediately.

Correct answer: C

Rationale: According to Watson's theory, a caring approach is essential. Confronting the nurse privately, ordering drug testing, and suggesting a substance abuse program demonstrates empathy and supports the staff member in seeking help for their addiction. This approach aligns with the principles of human caring and compassion, focusing on the well-being and recovery of the individual rather than punitive measures. Choices A and D are too harsh and lack empathy, not considering the individual's well-being or offering support for rehabilitation. Choice B is inappropriate and punitive, not aligned with a caring and compassionate approach as advocated by Watson's theory.

3. The nurse is providing pre-operative teaching to the anxious patient, who doesn't seem to be learning. What need must the nurse help this patient meet before continuing to teach?

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

Correct answer: C

Rationale: The correct answer is C: Safety. Before effective learning can occur, the patient's safety needs must be addressed. When patients feel safe and secure, they are better able to focus on receiving and processing information. Ensuring the patient's safety is a fundamental step in providing care and support, especially in a pre-operative setting where anxiety and concerns about the procedure may be high. Choices A, B, and D are incorrect because while self-esteem, love and belonging, and self-actualization are important needs, the immediate priority in this scenario is addressing the patient's safety concerns to create a conducive environment for learning.

4. What theme of critical thinking is demonstrated by the belief that continuous learning contributes to the ongoing process?

• A. Critical thinking is a productive and positive activity.
• B. Critical thinking is a process, not an outcome.
• C. Manifestations of critical thinking vary, depending on the context in which they occur.
• D. Critical thinking is triggered by both positive and negative events.

Correct answer: B

Rationale: The belief that continuous learning contributes to the ongoing process aligns with the theme that critical thinking is a process, not an outcome. This suggests that critical thinking involves a continuous, dynamic process of evaluating information, making connections, and adapting one's thinking over time, rather than being a fixed end result. Therefore, choice B is the correct answer. Choices A, C, and D do not directly address the continuous nature of critical thinking or its ongoing development, making them incorrect.

5. 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.

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