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 is the difference between the LPN and LVN nursing titles?

• A. LPNs and LVNs have the same educational program length.
• B. LVNs and LPNs have the same duties and skills but hold different titles.
• C. LVNs are able to perform venipuncture, whereas LPNs cannot.
• D. LPNs can pursue an RN license, while LVNs are not on the same path.

Correct answer: B

Rationale: The correct answer is B. LVNs and LPNs have the same duties and skills but hold different titles. The distinction between the two titles is primarily regional, with some states using LPN (Licensed Practical Nurse) and others using LVN (Licensed Vocational Nurse) to refer to the same role. Their scope of practice, responsibilities, and educational requirements are essentially equivalent, with the only notable difference being the title itself. Choices A, C, and D are incorrect because LPNs and LVNs generally have similar educational program lengths, both can perform venipuncture, and both have the potential to pursue further education and licensure to become registered nurses (RNs) if they choose to do so.

3. 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.

4. When transitioning from a long-term care facility to an acute care facility, what does the nurse need to do?

• A. Adapt motivational approaches
• B. Increase working hours per week
• C. Pursue additional formal education
• D. Maintain the same patient care time

Correct answer: A

Rationale: When transitioning from a long-term care facility to an acute care facility, the nurse needs to adapt motivational approaches. The environment and patient needs change significantly between these settings. Adapting motivational approaches is crucial to effectively meet the demands of the new job and provide optimal care in the acute care setting. This adjustment allows the nurse to cater to the different needs and pace of care required in an acute care facility compared to a long-term care facility. Choices B, C, and D are incorrect as they do not address the specific need for adapting motivational approaches when transitioning between these types of healthcare facilities.

5. A healthcare professional walks into the nurse's station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions should the healthcare professional take first?

• A. remind the staff members that this is a breach of confidentiality
• B. discuss the issue with the unit manager
• C. request that an administrative restriction be placed on the client's medical access
• D. prepare a report for the facility ethics committee

Correct answer: A

Rationale: The correct action for the healthcare professional to take first is to remind the staff members that accessing the electronic medical record of a celebrity client from another unit is a breach of confidentiality. This immediate action addresses the ethical and legal issue at hand, emphasizing the importance of patient confidentiality and privacy. Discussing the issue with the unit manager, requesting administrative restrictions, or preparing a report for the facility ethics committee can be considered after addressing the initial breach and reminding staff members of their obligations.

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