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. What may the patient's statement, 'I cannot read until I get my glasses,' indicate?

• A. The patient is embarrassed about needing glasses
• B. The patient has visual impairment
• C. The patient may be illiterate
• D. The patient is being uncooperative

Correct answer: C

Rationale: The patient stating they cannot read until they get their glasses suggests a potential issue with literacy rather than visual impairment or unwillingness to cooperate. This statement should prompt further assessment to determine the patient's reading abilities and potential literacy needs. Choice A is incorrect as the statement does not directly imply embarrassment. Choice B is incorrect as the statement does not necessarily indicate a visual impairment. Choice D is incorrect as there is no clear evidence of the patient being uncooperative based on the provided statement.

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. Nurses on a unit provide personal hygiene, administer medications, educate patients, and provide emotional support. The nurses are providing patient care based on which nursing delivery system?

• A. total patient care
• B. team nursing
• C. functional nursing
• D. partnership nursing

Correct answer: A

Rationale: The correct answer is A, total patient care. Total patient care refers to a nursing delivery system where one nurse is responsible for providing all aspects of care to the patient. In this system, the nurse assumes full responsibility for the patient's care, including personal hygiene, medication administration, patient education, and emotional support, ensuring comprehensive and individualized care. Choice B, team nursing, involves a team of healthcare providers working together to provide care to a group of patients. Choice C, functional nursing, divides tasks among different team members based on their skills and expertise. Choice D, partnership nursing, does not represent a recognized nursing delivery system, making it an incorrect option.

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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