Nursing Elites

1. Who were the first public health nurses who provided care for the sick and the poor?

• A. The Presbyterian Church
• B. Salerno
• C. Jewish scholars
• D. Convent deaconesses

Correct answer: D

Rationale: The correct answer is D, Convent deaconesses. Deaconesses from local convents were the first public health nurses who provided care for the sick and the poor. They exemplified care guided by the Christian belief in compassion and helping others. The other choices (A, B, C) are incorrect because the Presbyterian Church, Salerno, and Jewish scholars were not specifically mentioned as the pioneers of public health nursing. The extract highlights the significant role of convent deaconesses in laying the foundation for modern public health nursing.

2. When the new graduate nurse shares a journal article about caring with peers, a more experienced nurse says, 'You’d be a lot better off studying pathophysiology instead of wasting time on caring.' How does the graduate interpret the experienced nurse’s comment?

• A. The experienced nurse is just mean and doesn’t like new graduates.
• B. The experienced nurse is most likely overworked and cranky.
• C. The experienced nurse was educated in the medical model.
• D. The experienced nurse is uncaring and dislikes new graduates.

Correct answer: C

Rationale: The experienced nurse's comment likely reflects their education in the medical model, which emphasizes technical skills over caring. This suggests a difference in educational background rather than personal animosity towards new graduates. Choice A is incorrect as it assumes personal dislike without considering educational differences. Choice B is incorrect as it attributes the behavior to being overworked and cranky, which is not supported by the information given. Choice D is incorrect as it makes a broad assumption about the experienced nurse's character without considering the context of their comment.

3. The increasing use of licensed practical nurses (LPNs) in management positions, especially in long-term care facilities, is an example of what?

• A. Assertive management
• B. A shifting paradigm
• C. Critical thinking
• D. Smarter LPN graduates

Correct answer: B

Rationale: The correct answer is B: A shifting paradigm. The increasing use of LPNs in management positions, particularly in long-term care facilities, represents a changing paradigm in healthcare management. This shift indicates a move towards assigning leadership responsibilities to LPNs, signaling a departure from traditional industry roles. Choices A, C, and D are incorrect because the situation described does not primarily demonstrate assertive management, critical thinking, or the intelligence of LPN graduates. The focus is on the evolving role of LPNs in management, suggesting a broader change in healthcare practices.

4. The patient tells the nurse that his insurance company requires him to pick a primary provider and asks what that means. The nurse explains that a primary provider means choosing what?

• A. A doctor
• B. A staff nurse
• C. One insurance provider
• D. A hospital

Correct answer: A

Rationale: A primary provider is typically a doctor, nurse practitioner, or physician's assistant who is responsible for overseeing and coordinating the patient's comprehensive healthcare needs. This healthcare professional serves as the main point of contact for the patient, managing preventive care, treatments, referrals to specialists, and overall health management. Choice B, a staff nurse, is incorrect as a primary provider is usually a more advanced healthcare professional managing comprehensive care. Choice C, one insurance provider, is incorrect as a primary provider refers to a healthcare professional, not an insurance company. Choice D, a hospital, is incorrect as the primary provider is an individual healthcare professional responsible for coordinating the patient's care, not a healthcare facility.

5. 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.

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