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. 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. In a system of care delivery in which RNs, LPNs, and unlicensed assistive personnel implement specific tasks like medication administration or personal hygiene for the entire nursing unit, what term describes this type of delivery system?

• A. Primary nursing
• B. Team nursing
• C. Functional nursing
• D. Total patient care

Correct answer: C

Rationale: Functional nursing is a care delivery model where tasks are divided among team members based on their respective roles. In this system, RNs, LPNs, and unlicensed assistive personnel are assigned specific tasks to carry out for the entire nursing unit, such as medication administration or personal hygiene duties. The other choices are incorrect: A) Primary nursing involves one nurse being responsible for all aspects of care for a group of patients, B) Team nursing involves a team of healthcare providers working together to provide care for a group of patients, and D) Total patient care refers to one nurse being responsible for all aspects of care for one patient.

4. In a unionized hospital, nurses receive compensatory pay for working holidays based on the hours worked with no extra compensation. Despite management refusing to consider changes to the compensatory pay system suggested by nurses during the annual employee satisfaction survey, a trend member listened to both parties and made non-legally binding recommendations. What is this type of settlement known as?

• A. Collective bargaining
• B. Mediation
• C. Grievance
• D. Binding arbitration

Correct answer: B

Rationale: Mediation involves a neutral third party who assists in resolving disputes by providing non-legally binding recommendations. In this scenario, the trend member acted as a mediator by listening to both nurses and management and offering suggestions without the authority to enforce them as a legally binding decision. Collective bargaining refers to negotiations between labor unions and employers to determine terms of employment. Grievance is a formal complaint by an employee against an employer. Binding arbitration involves a neutral third party making a final and legally binding decision to resolve a dispute.

5. A healthcare professional is reviewing a client's clinical pathway upon discharge following hip arthroplasty. Which of the following information can assist in evaluating the cost-effectiveness of the care?

• A. the age of the client
• B. the availability of community support groups
• C. the length of the client's stay
• D. the type of insurance the client carries

Correct answer: C

Rationale: The correct answer is C: 'the length of the client's stay.' The length of the client's stay is a critical factor in determining the cost-effectiveness of care after hip arthroplasty. Shorter stays typically result in lower costs as they reduce resource utilization and associated expenses. Choices A, B, and D are not directly related to evaluating cost-effectiveness in this scenario. The age of the client, availability of community support groups, and the type of insurance carried may impact other aspects of care but do not directly assess the cost-effectiveness of the care provided.

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