Nursing Elites

1. When considering factors like high risk for falls, infection protocols, and special communication needs to determine the mix and number of staff needed on a telemetry unit, what is being utilized?

• A. diagnostic related groups
• B. clinical pathways
• C. case management
• D. Patient classification system

Correct answer: D

Rationale: In this scenario, the nurse is using a Patient Classification System, which helps in determining the appropriate staffing levels based on the acuity and care requirements of the patients in the telemetry unit. By considering factors like high risk for falls, infection protocols, and special communication needs, the nurse can allocate the right mix and number of staff to provide safe and effective care. The other choices are incorrect because diagnostic related groups are used for billing purposes, clinical pathways are standard care plans for specific diagnoses, and case management involves coordinating care and services for patients.

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. What is the most caring response the student can make in this situation?

• A. Tell the other students that they are being mean and then leave the table.
• B. Shame the students for being so uncaring and cruel.
• C. Ask the other students why they think the instructor is so picky.
• D. Laugh and tell a story of a personal reprimand received from the instructor.

Correct answer: C

Rationale: Choosing to ask the other students why they think the instructor is so picky is a caring response as it opens up a constructive conversation. This approach can help shift the focus from making fun of the instructor to understanding the reasons behind their behavior, fostering empathy, and potentially promoting a more respectful environment. Option A may address the behavior but does not promote understanding. Option B focuses on shaming, which may escalate the situation. Option D diverts attention from the issue and may perpetuate a negative atmosphere.

4. When demonstrating therapeutic use of self, which nursing intervention is the nurse performing?

• A. Sitting with a dying patient
• B. Attending class
• C. Studying for a test
• D. Learning the nursing code of ethics

Correct answer: A

Rationale: The correct answer is A: Sitting with a dying patient. Therapeutic use of self in nursing involves the nurse's ability to establish a caring and compassionate relationship with patients. Sitting with a dying patient allows the nurse to provide emotional support, physical presence, and comfort, demonstrating the use of self in a therapeutic manner. Choices B, C, and D are incorrect as they do not directly involve the nurse's interaction with a patient in a therapeutic manner.

5. How can a student best prepare for a clinical experience?

• A. Practice and review procedures for performing skills
• B. Review class notes from the past week
• C. Familiarize oneself with the clinical facility
• D. Arrive at the clinical site 1 hour early

Correct answer: A

Rationale: Practicing and reviewing procedures for performing skills is crucial for a student preparing for a clinical experience. This preparation allows the student to build competence and confidence in executing required tasks. Reviewing class notes may be helpful for theoretical knowledge but may not adequately prepare the student for practical skills needed in a clinical setting. Familiarizing oneself with the clinical facility is beneficial but does not directly address skill readiness. Arriving early is important but does not substitute for the essential preparation of practicing and reviewing procedures for performing skills.

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