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 can a healthcare provider best address the spiritual aspect of caring for a patient?

• A. Explain the patient's spiritual beliefs to the healthcare provider.
• B. Ask the patient to share their spiritual beliefs.
• C. Ask what the patient requires to meet their spiritual needs.
• D. Consult with a spiritual leader to understand the patient's spiritual needs.

Correct answer: C

Rationale: The most effective way for a healthcare provider to address the spiritual aspect of caring for a patient is by asking what the patient requires to meet their spiritual needs. This approach respects the patient's autonomy, acknowledges their individual beliefs, and allows for personalized and patient-centered care. Choice A is incorrect as it focuses on the healthcare provider's understanding rather than the patient's needs. Choice B could be invasive and may not be necessary to provide adequate spiritual care. Choice D involves consulting a spiritual leader, which may not always align with the patient's personal beliefs and preferences.

3. If a nurse accepts the role of charge nurse on the evening shift, what effect will unionization have on the nurse's new position?

• A. The nurse can file a grievance that will be arbitrated automatically by the Union
• B. Charge nurse is part of the management team, so Union participation would be a conflict of interest
• C. The nurse is not eligible for collective bargaining activities dealing with unfair labor practices
• D. The nurse can be represented by the union because charge nurses are not considered part of the management team

Correct answer: B

Rationale: Choosing answer B is correct because charge nurses are typically considered part of the management team. As part of the management team, the charge nurse has decision-making responsibilities that align with the interests of the organization. Therefore, participating in a union would create a conflict of interest. Options A, C, and D are incorrect. Option A is incorrect because union arbitration is not typically applicable to management positions. Option C is incorrect because charge nurses, as part of the management team, would not be eligible for collective bargaining activities like frontline staff. Option D is incorrect because charge nurses, due to their managerial responsibilities, are generally not represented by unions for collective bargaining purposes.

4. 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.

5. What theme of critical thinking is demonstrated when an individual decides to return to school to obtain a bachelor of science degree in nursing?

• A. Critical thinking involves both productive and positive activities.
• B. Critical thinking is a process, not an outcome.
• C. Manifestations of critical thinking vary based on the context in which they occur.
• D. Critical thinking is triggered by both positive and negative events.

Correct answer: D

Rationale: The decision to return to school to obtain a bachelor of science degree in nursing can be triggered by various factors, both positive (like a desire for career advancement) and negative (like feeling limited without the degree). This decision reflects critical thinking as it involves a thoughtful evaluation of personal and professional goals, weighing potential benefits and consequences. Therefore, the theme of critical thinking demonstrated in this scenario is that critical thinking is triggered by both positive and negative events. Choices A, B, and C are incorrect because they do not specifically address the concept of critical thinking being influenced by positive and negative events as demonstrated in the scenario.

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