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. How is motivation typically described?

• A. As a stagnant, unchanging force
• B. As a fluid, dynamic process that changes over time
• C. As a process that requires great force to change
• D. As a process that differs every day

Correct answer: B

Rationale: Motivation is commonly described as a fluid and dynamic process that evolves and changes over time. It is not stagnant but rather fluctuates based on various internal and external factors. Choice A is incorrect as motivation is not stagnant but dynamic. Choice C is incorrect as motivation does not necessarily require great force to change. Choice D is incorrect as motivation is not something that differs drastically every day, but rather changes gradually over time.

3. The nurse overhears a physician yelling at a newly hired graduate nurse in the hall. What is the nurse's best caring response?

• A. Yell at the physician for yelling at a new graduate and report the incident to the supervisor.
• B. Wait until the situation ends and comfort the graduate privately.
• C. Suggest that the physician take a quieter and more private approach to the problem.
• D. Ignore the situation to avoid embarrassing the graduate further.

Correct answer: C

Rationale: Suggesting a quieter and more private approach to the problem is the best caring response as it addresses the issue respectfully. This response shows empathy towards the graduate nurse and also aims to improve the situation without escalating it further. Choice A is not ideal as responding to yelling with yelling can exacerbate the situation and create more tension. Choice B, while offering comfort, does not directly address the inappropriate behavior of the physician. Choice D is not recommended as ignoring the situation may not help the graduate nurse and can lead to the continuation of inappropriate behavior without intervention.

4. How does the high degree of professionalism among nurses impact their willingness to engage in organized strikes?

• A. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession
• B. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization
• C. Nurses who strike can be legally punished for abandonment and negligence considered to be professional misconduct
• D. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client's safety initiatives

Correct answer: A

Rationale: The correct answer is A. The high level of professionalism among nurses, as recognized in Gallup polls, often leads them to perceive organized strikes as conflicting with their duty to care for patients and uphold their professional standards. This conflict of interest can cause nurses to be hesitant or reluctant to participate in strikes. Choice B is incorrect because nurses' decision to engage in strikes is more influenced by professional values and patient care rather than evidence-based studies on management and labor views. Choice C is incorrect because while legal consequences may be a concern, the primary factor influencing nurses' decision on strikes is their professional commitment to patient care. Choice D is incorrect as nurses' focus during strikes is more on advocating for patient safety rather than emphasizing safety initiatives.

5. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

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