Nursing Elites

1. 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.

2. On what basis does the U.S. healthcare system operate?

• A. Healthcare is a basic right provided to all equally.
• B. Ability to pay determines access to care.
• C. Only the rich are entitled to healthcare.
• D. Health insurance is required to obtain care.

Correct answer: B

Rationale: The correct answer is B. In the U.S., the healthcare system operates on a model where access to healthcare services is largely determined by an individual's ability to pay for care. This means that those with more financial resources have greater access to a wider range of healthcare services, while those with limited financial means may face barriers to accessing necessary care. Choices A, C, and D are incorrect because healthcare in the U.S. is not universally provided as a basic right to all equally, it is not exclusively for the rich, and while health insurance is common, it is not the sole determinant of access to care.

3. When caring for a patient who just received a terminal diagnosis and is tearful and frightened, what is the best action to demonstrate caring?

• A. Call the patient's spiritual leader to talk to the patient.
• B. Call the patient's family and ask them to come sit with the patient.
• C. Cry with the patient while sympathizing with their situation.
• D. Sit with the patient and listen to their fears.

Correct answer: D

Rationale: In situations where a patient receives a terminal diagnosis and is emotionally distressed, it is essential to provide empathy and support. Sitting with the patient and actively listening to their fears allows the patient to express their emotions and concerns. This action demonstrates genuine care and compassion, showing the patient that their feelings are acknowledged and valued. It creates a therapeutic environment that fosters trust and emotional well-being, helping the patient cope with the distressing news. Calling the patient's spiritual leader (Choice A) may not address the immediate emotional needs of the patient. Calling the patient's family (Choice B) can be comforting but might not directly address the patient's fears. Crying with the patient (Choice C) can blur professional boundaries and may not be as beneficial as actively listening and providing support.

4. When demonstrating therapeutic use of self, which nursing intervention is the nurse performing?

• A. Sitting with a dying patient
• B. Attending class
• C. Studying for a test
• D. Learning the nursing code of ethics

Correct answer: A

Rationale: The correct answer is A: Sitting with a dying patient. Therapeutic use of self in nursing involves the nurse's ability to establish a caring and compassionate relationship with patients. Sitting with a dying patient allows the nurse to provide emotional support, physical presence, and comfort, demonstrating the use of self in a therapeutic manner. Choices B, C, and D are incorrect as they do not directly involve the nurse's interaction with a patient in a therapeutic manner.

5. What is the most caring response the student can make in this situation?

• A. Tell the other students that they are being mean and then leave the table.
• B. Shame the students for being so uncaring and cruel.
• C. Ask the other students why they think the instructor is so picky.
• D. Laugh and tell a story of a personal reprimand received from the instructor.

Correct answer: C

Rationale: Choosing to ask the other students why they think the instructor is so picky is a caring response as it opens up a constructive conversation. This approach can help shift the focus from making fun of the instructor to understanding the reasons behind their behavior, fostering empathy, and potentially promoting a more respectful environment. Option A may address the behavior but does not promote understanding. Option B focuses on shaming, which may escalate the situation. Option D diverts attention from the issue and may perpetuate a negative atmosphere.

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