Nursing Elites

1. 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.

2. 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.

3. The nurse listens as the physician asks the patient to participate in a research study and realizes the physician is not adequately explaining the risks of the study. As they leave the patient's room, the nurse encourages the physician to go back and explain the risks more thoroughly. What role is this nurse playing in patient care?

• A. Teacher
• B. Caregiver
• C. Advocate
• D. Communicator

Correct answer: C

Rationale: The nurse is acting as an advocate by ensuring the patient is fully informed before consenting to participate in the study. Advocacy in healthcare involves supporting and promoting the patient's rights, including the right to be fully informed about their care and treatment options. By advocating for the patient in this scenario, the nurse is prioritizing the patient's well-being and autonomy. Choices A, B, and D are incorrect. The nurse is not acting as a teacher, caregiver, or communicator specifically in this scenario, but rather advocating for the patient's right to informed consent.

4. 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.

5. A group of workers wish to seek union representation that would protect all workers in the agency, including unlicensed assistive personnel and non-nursing employees such as a nutritionist and dietary workers. The type of union being sought is the strongest collective group and is known by what term?

• A. A right-to-work bargaining organization
• B. An occupational union
• C. Industrial unionism
• D. Union shop

Correct answer: C

Rationale: Industrial unionism refers to a union that represents all workers in a particular industry, regardless of their specific job roles. In this scenario, the workers are looking for a union that covers a wide range of employees in the agency, making industrial unionism the most suitable option. Choice A, 'A right-to-work bargaining organization,' is incorrect as right-to-work laws pertain to union security agreements and do not define the type of union being sought. Choice B, 'An occupational union,' is incorrect as it typically represents workers within a specific occupation, not across various roles as described in the scenario. Choice D, 'Union shop,' is incorrect as it refers to a workplace where employees are required to join or pay union dues as a condition of employment, which is different from the scenario described.

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