Nursing Elites

1. When teaching about community preparedness for a community group, the nurse should explain that the components of the national disaster medical system (NDMS) provide assistance in what form?

• A. making available a nationwide bomb disposal squad team for the rapid removal of explosive devices
• B. Facilitating patient evacuation from the disaster area to a non-affected area
• C. organizing ground for detonation of bombs by bomb squad
• D. providing mental health care for victims and healthcare providers in the community

Correct answer: B

Rationale: The correct answers are B and C. The NDMS is designed to provide medical response during disasters, assist in patient movement, and offer definitive care to disaster victims. This includes organizing teams of healthcare providers with specialized skills and equipment to respond effectively to emergencies. Patient evacuation from disaster areas to safer locations is also a key function of the NDMS to ensure the well-being of those affected by the disaster. Options A and D are incorrect because the NDMS does not provide bomb disposal services and is primarily focused on medical response rather than mental health care.

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. Which role is not appropriate for the LPN to participate in?

• A. Administering medications
• B. Dressing changes
• C. Designing a research study
• D. Reporting patient changes

Correct answer: C

Rationale: The correct answer is C. Designing a research study is not typically within the scope of practice for a Licensed Practical Nurse (LPN). LPNs are primarily involved in providing direct patient care, such as administering medications, performing dressing changes, and reporting patient changes. Designing research studies usually requires advanced education and training beyond what an LPN receives, making it an inappropriate role for an LPN to participate in.

4. The nurse overhears a physician yelling at a newly hired graduate nurse in the hall. What is the nurse's best caring response?

• A. Yell at the physician for yelling at a new graduate and report the incident to the supervisor.
• B. Wait until the situation ends and comfort the graduate privately.
• C. Suggest that the physician take a quieter and more private approach to the problem.
• D. Ignore the situation to avoid embarrassing the graduate further.

Correct answer: C

Rationale: Suggesting a quieter and more private approach to the problem is the best caring response as it addresses the issue respectfully. This response shows empathy towards the graduate nurse and also aims to improve the situation without escalating it further. Choice A is not ideal as responding to yelling with yelling can exacerbate the situation and create more tension. Choice B, while offering comfort, does not directly address the inappropriate behavior of the physician. Choice D is not recommended as ignoring the situation may not help the graduate nurse and can lead to the continuation of inappropriate behavior without intervention.

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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