Nursing Elites

1. 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.

2. Which historical figure is honored for working to improve care of the mentally ill in mental health nursing?

• A. Clara Barton
• B. Florence Nightingale
• C. Dorothea Dix
• D. Lillian D. Wald

Correct answer: C

Rationale: Dorothea Dix is the correct answer. She is recognized for her significant contributions in advocating for the improvement of care for the mentally ill. Dix played a crucial role in establishing mental health institutions and reforming the care provided to individuals with mental health conditions. Clara Barton is known for founding the American Red Cross, Florence Nightingale is renowned as the founder of modern nursing, and Lillian D. Wald is recognized for her work in public health nursing. However, none of them are specifically honored for their work in improving care for the mentally ill in mental health nursing, unlike Dorothea Dix.

3. 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.

4. The healthcare provider is caring for an adolescent who will be hospitalized for several weeks while in traction. The patient frequently has a room full of friends, and they can be heard laughing. The healthcare provider recognizes this patient is meeting which of Maslow's hierarchy of needs?

• A. Self-esteem
• B. Love and belonging
• C. Safety
• D. Self-actualization

Correct answer: B

Rationale: Love and belonging needs, as per Maslow's hierarchy, refer to the sense of belonging, being accepted, and forming meaningful relationships. In this scenario, the patient having friends around and engaging in social interactions indicates fulfillment of the love and belonging need. Choice A, self-esteem, focuses on self-respect and confidence, which are not directly related to the patient's interaction with friends. Choice C, safety, involves physical and psychological safety, which may be important but not the primary need being met in this situation. Choice D, self-actualization, relates to realizing personal potential, creativity, and achieving goals, which are at a higher level in the hierarchy compared to the need for love and belonging.

5. Why is critical thinking necessary for identifying and understanding paradigms that exist in nursing practice?

• A. Critical thinking allows for the nurse to make superficial decisions.
• B. Critical thinking allows the nurse to thoroughly examine situations and issues.
• C. Critical thinking provides the nurse with quick answers.
• D. Critical thinking allows the nurse to accept information without needing to check its validity.

Correct answer: B

Rationale: Critical thinking is essential for nurses to identify and understand paradigms in nursing practice because it enables them to thoroughly examine complex situations and issues. By critically analyzing information and considering various perspectives, nurses can gain a deeper understanding of the underlying paradigms that shape nursing practice. This thorough examination helps nurses make informed decisions and provide high-quality care to patients. Choice A is incorrect because critical thinking involves deeper analysis, not superficial decisions. Choice C is incorrect because critical thinking does not provide quick answers; it involves a systematic and thoughtful approach. Choice D is incorrect because critical thinking encourages nurses to question information and verify its validity rather than accepting it blindly.

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