Nursing Elites

1. 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.

2. In an underdeveloped country, the nurse observes the natives lighting ritual fires and pounding on primitive drums around the sick person to promote recovery. The nurse interprets this behavior as indicating the natives believe illness results from which items?

• A. Pathogens and genetics
• B. Evil spirits
• C. Tides and planets
• D. Plants and animals

Correct answer: B

Rationale: The behavior of lighting fires and pounding on drums to promote recovery suggests a belief in evil spirits causing illness. In many cultures, rituals like these are performed to ward off evil spirits or negative energies that are thought to be the cause of sickness. Choices A, C, and D are incorrect as the described behavior aligns more with spiritual or supernatural beliefs rather than scientific explanations related to pathogens, genetics, tides, planets, plants, or animals.

3. When a nurse reads a peer-reviewed nursing journal article recommending a change in caring for a patient with an indwelling urinary catheter, which action demonstrates critical thinking?

• A. Implementing the article's recommendations in caring for a patient with an indwelling urinary catheter
• B. Presenting the journal article to the nurse manager and proposing a revision of the procedure
• C. Seeking additional peer-reviewed articles that corroborate the author's recommendation
• D. Disregarding the article and adhering to the facility's existing procedure

Correct answer: C

Rationale: Critical thinking involves evaluating information from various sources. In this scenario, the nurse displays critical thinking by seeking additional peer-reviewed articles that support the author's recommendation. This action ensures that decisions are based on a comprehensive understanding of the topic rather than relying solely on one source. By exploring other peer-reviewed articles, the nurse can validate the proposed change and make informed decisions regarding patient care. Choice A, implementing the article's recommendations, may not encompass a thorough evaluation of the information presented. Choice B, presenting the article to the nurse manager, is a valid step but does not directly involve critical analysis of the information. Choice D, disregarding the article, goes against the essence of critical thinking, which emphasizes the evaluation and consideration of various perspectives.

4. Nurses and community officials are working together to ensure that churches and schools have needed supplies to provide shelter for a large number of individuals in the event of a natural or man-made disaster. These activities represent which phase of a disaster continuum?

• A. Crisis Intervention
• B. Preparedness
• C. Recovery
• D. Relief Response

Correct answer: B

Rationale: The scenario described in the question, where nurses and community officials are preparing churches and schools with supplies for potential disaster situations, falls under the Preparedness phase of a disaster continuum. Preparedness involves planning, organizing, and equipping to handle potential disasters before they occur. This phase aims to enhance the readiness of individuals, organizations, and systems to respond effectively when a disaster strikes. Choices A, C, and D are incorrect because they do not align with the activities of preparing for a disaster before it happens; Crisis Intervention deals with immediate response during or after a disaster, Recovery focuses on rebuilding and restoring after a disaster, and Relief Response involves providing immediate assistance in the aftermath of a disaster.

5. 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.

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