Nursing Elites

1. Which action directly resulted from the contribution made by Linda Richards?

• A. Using an antiseptic before administering an injection
• B. Exploring the psychosocial needs of the patient
• C. Documenting patient care in the medical record
• D. Listening to a patient describe his or her symptoms

Correct answer: C

Rationale: The correct answer is C: Documenting patient care in the medical record. Linda Richards' contribution was developing a system for recording patient details and care, leading to modern medical records. This innovation directly resulted in the practice of documenting patient care in medical records, ensuring accurate and organized patient information for effective healthcare delivery. Choices A, B, and D are incorrect because they do not directly stem from Richards' specific contribution related to medical records.

2. 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.

3. 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.

4. What is the difference between mediation and binding arbitration based on the statement provided?

• A. Mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor
• B. Mediation uses a trained person to facilitate negotiations without making a final decision
• C. Binding arbitration is a formal process where an arbitrator's decision is final and must be adhered to by both parties
• D. Binding arbitration requires both labor and management to engage in discussions to find the least harmful resolution

Correct answer: C

Rationale: The key difference between mediation and binding arbitration lies in the finality of the decision. In binding arbitration, the arbitrator's decision is ultimate, and both parties are obligated to comply with it. This differs from mediation, where a neutral third party facilitates negotiations but does not make a final decision. Choice A is incorrect as mediation is not necessarily sanctioned by the NLRB; it can be conducted independently. Choice B is incorrect because mediation does not involve a final decision-maker but focuses on facilitating discussions. Choice D is incorrect as binding arbitration does not aim to find the least harmful resolution but rather a final and binding decision by the arbitrator.

5. Which action demonstrates a coparticipative manner in the nursing model of care?

• A. Working with the patient and family to achieve the best outcome.
• B. Encouraging the shy student to participate in class discussions, demonstrating transpersonal caring.
• C. Finding a way for a patient to see a dog, understanding the patient's needs.
• D. Accepting individuals for who they are, maintaining a nonjudgmental attitude.

Correct answer: A

Rationale: A coparticipative manner in the nursing model of care involves collaborating with the patient and family to achieve the best outcome. This approach emphasizes working together as a team to address healthcare needs and make decisions. While encouraging a shy student, understanding a patient's needs, and maintaining a nonjudgmental attitude are all important aspects of nursing care, the coparticipative manner specifically focuses on partnership and shared decision-making in the care process.

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