Nursing Elites

1. While supervising the care of several clients, which action requires intervention by the charge nurse?

• A. A nurse photocopies a client's diagnostic test results.
• B. An assistive personnel documents the client's vital signs on the client's paper-based graphic record.
• C. The unit secretary faxes a client's laboratory results to the provider.
• D. An RN stays with a client to discuss her understanding of her vital signs that were requested.

Correct answer: A

Rationale: The charge nurse should intervene when a nurse photocopies a client's diagnostic test results as it violates patient confidentiality and privacy. This action breaches HIPAA regulations, and sensitive patient information should not be photocopied without proper authorization. The other actions are within the scope of practice and do not raise concerns regarding patient privacy or confidentiality.

2. The healthcare provider is caring for an adolescent who will be hospitalized for several weeks while in traction. The patient frequently has a room full of friends, and they can be heard laughing. The healthcare provider recognizes this patient is meeting which of Maslow's hierarchy of needs?

• A. Self-esteem
• B. Love and belonging
• C. Safety
• D. Self-actualization

Correct answer: B

Rationale: Love and belonging needs, as per Maslow's hierarchy, refer to the sense of belonging, being accepted, and forming meaningful relationships. In this scenario, the patient having friends around and engaging in social interactions indicates fulfillment of the love and belonging need. Choice A, self-esteem, focuses on self-respect and confidence, which are not directly related to the patient's interaction with friends. Choice C, safety, involves physical and psychological safety, which may be important but not the primary need being met in this situation. Choice D, self-actualization, relates to realizing personal potential, creativity, and achieving goals, which are at a higher level in the hierarchy compared to the need for love and belonging.

3. 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.

4. A healthcare professional is reviewing the plan of care for a client following a total hip arthroplasty. Which of the following procedural plans is the healthcare professional following?

• A. patient classification categories
• B. diagnostic related groups
• C. Care map / clinical practice guideline
• D. functional nursing

Correct answer: C

Rationale: A care map or clinical practice guideline is a standardized plan of care that outlines the recommended interventions and treatments for patients with a specific condition. In this scenario, following a total hip arthroplasty, healthcare professionals typically refer to a care map or clinical practice guideline to ensure the patient receives appropriate care based on evidence-based practices and standards. Choices A, B, and D are incorrect in this context. Patient classification categories refer to grouping patients based on care needs, diagnostic related groups are used for billing purposes, and functional nursing is a care delivery system that assigns specific tasks to nursing personnel.

5. A healthcare provider is planning the discharge of a newborn who requires apnea monitoring at home. To which of the following community agencies should the healthcare provider anticipate referring the guardian of the newborn?

• A. Child Protective Services
• B. Public Health
• C. Home Health
• D. Women, Infants, and Children (WIC)

Correct answer: C

Rationale: Home health agencies specialize in providing at-home care and monitoring services, making them the appropriate referral for a newborn requiring apnea monitoring. These agencies can offer skilled nursing care, education, and support to ensure the well-being of the newborn in a home setting. Child Protective Services (Choice A) is not relevant in this scenario as it deals with child welfare and protection from abuse or neglect. Public Health (Choice B) focuses on community health initiatives but may not provide the specialized care needed for apnea monitoring. Women, Infants, and Children (WIC) program (Choice D) offers nutritional support and education for low-income pregnant women, new mothers, and young children, which is not directly related to providing monitoring services for a newborn with apnea.

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