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 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.

3. The nurse is caring for a patient transferred from the local prison who was arrested and convicted of child sexual abuse. The nurse feels disgust for the patient's behavior but can avoid being judgmental by understanding what?

• A. Motivation
• B. State laws
• C. The patient's social history
• D. Code of ethics

Correct answer: A

Rationale: In this scenario, the nurse is experiencing negative emotions towards the patient's behavior. By understanding the patient's motivation, the nurse can gain insight into the underlying factors that led to the behavior, helping to avoid being judgmental. This approach allows the nurse to provide care and support without letting personal feelings interfere. Understanding motivation can also aid in developing a therapeutic relationship and providing appropriate care tailored to the patient's needs. Choices B, C, and D are incorrect as while state laws, the patient's social history, and the code of ethics are important aspects to consider in healthcare, they do not directly address the nurse's feelings of disgust and the need to avoid being judgmental towards the patient's behavior.

4. A group of workers wish to seek union representation that would protect all workers in the agency, including unlicensed assistive personnel and non-nursing employees such as a nutritionist and dietary workers. The type of union being sought is the strongest collective group and is known by what term?

• A. A right-to-work bargaining organization
• B. An occupational union
• C. Industrial unionism
• D. Union shop

Correct answer: C

Rationale: Industrial unionism refers to a union that represents all workers in a particular industry, regardless of their specific job roles. In this scenario, the workers are looking for a union that covers a wide range of employees in the agency, making industrial unionism the most suitable option. Choice A, 'A right-to-work bargaining organization,' is incorrect as right-to-work laws pertain to union security agreements and do not define the type of union being sought. Choice B, 'An occupational union,' is incorrect as it typically represents workers within a specific occupation, not across various roles as described in the scenario. Choice D, 'Union shop,' is incorrect as it refers to a workplace where employees are required to join or pay union dues as a condition of employment, which is different from the scenario described.

5. 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.

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