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. On what are most nursing paradigms based?

• A. The nurse's ability to perform procedures with skill
• B. Dr. Jean Watson's transpersonal caring theory
• C. Maslow's theory of hierarchy of needs
• D. Learning by studying nursing theories and clinical experiences

Correct answer: D

Rationale: Most nursing paradigms are founded on the understanding and application of nursing theories through studying them and gaining practical experiences in clinical settings. While the nurse's ability to perform procedures with skill is important, it is not the foundation of nursing paradigms. Dr. Jean Watson's transpersonal caring theory and Maslow's theory of hierarchy of needs are significant in nursing practice but do not serve as the basis for most nursing paradigms. Nursing paradigms are shaped by a combination of studying nursing theories and hands-on clinical experiences, which provide the foundational knowledge and practical skills needed for nursing practice.

3. 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.

4. What term is used to identify a situation where a specific target and method of attack are identified by a reliable source, such as a bomb in the possession of a known terrorist group targeting a government building in a local community?

• A. Credible threat
• B. Biological event
• C. National disaster
• D. All-hazards approach

Correct answer: A

Rationale: A credible threat is the correct term used to identify a situation where a reliable source specifies both the target and method of attack, such as a bomb possessed by a known terrorist group targeting a government building in a local community. This term signifies a serious and imminent danger substantiated by credible information. Choice B, 'Biological event,' is incorrect as it refers to a different type of threat involving pathogens or biological agents. Choice C, 'National disaster,' is also incorrect as it pertains to large-scale events causing significant harm to a country or region, not a specific targeted attack. Choice D, 'All-hazards approach,' is not the term used to describe a specific identified threat; instead, it refers to a comprehensive strategy that addresses all types of hazards and risks in emergency management.

5. 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.

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