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. What skills are required for an LPN to successfully manage care?

• A. The ability to organize and prioritize tasks
• B. The ability to work weekends and off shifts
• C. The ability to develop a comprehensive care plan
• D. Close relationship with the supervising RN

Correct answer: A

Rationale: To successfully manage care as an LPN, one must possess the ability to organize and prioritize tasks. This skill is crucial in ensuring efficient and effective care delivery, as it helps in planning, coordinating, and addressing patient needs in a timely manner. While the other choices may also be important in certain contexts, the key skill required for care management is the ability to organize and prioritize tasks. Working weekends and off shifts (Choice B) may be part of the job requirement but is not a skill. Developing a comprehensive care plan (Choice C) is important but falls more under the domain of care planning rather than day-to-day care management. Having a close relationship with the supervising RN (Choice D) is beneficial for collaboration but is not a standalone skill required for managing care.

3. What term is used to identify the care delivery model being used when a nurse makes patient care assignments as follows: RN1 has rooms 202-210, RN2 has rooms 211-221, RN3 has rooms 222-232. The unlicensed assistive personnel have half the rooms, with one assigned to 202-215 and the second to 216-232?

• A. Partnership
• B. Primary
• C. Modular
• D. Team

Correct answer: C

Rationale: The term used to identify the care delivery model being used in this scenario is 'Modular.' In modular nursing, a nursing unit is divided into modules, with each module staffed by a team assigned to specific rooms. This division allows for a more organized and efficient delivery of care, with clear assignments and responsibilities for each team. Choices A, B, and D are incorrect. Partnership typically refers to collaboration between healthcare providers; Primary is related to the patient's main healthcare provider; and Team is a general term that does not specifically describe the modular care delivery model outlined in the question.

4. On what basis does the U.S. healthcare system operate?

• A. Healthcare is a basic right provided to all equally.
• B. Ability to pay determines access to care.
• C. Only the rich are entitled to healthcare.
• D. Health insurance is required to obtain care.

Correct answer: B

Rationale: The correct answer is B. In the U.S., the healthcare system operates on a model where access to healthcare services is largely determined by an individual's ability to pay for care. This means that those with more financial resources have greater access to a wider range of healthcare services, while those with limited financial means may face barriers to accessing necessary care. Choices A, C, and D are incorrect because healthcare in the U.S. is not universally provided as a basic right to all equally, it is not exclusively for the rich, and while health insurance is common, it is not the sole determinant of access to care.

5. Who were the first public health nurses who provided care for the sick and the poor?

• A. The Presbyterian Church
• B. Salerno
• C. Jewish scholars
• D. Convent deaconesses

Correct answer: D

Rationale: The correct answer is D, Convent deaconesses. Deaconesses from local convents were the first public health nurses who provided care for the sick and the poor. They exemplified care guided by the Christian belief in compassion and helping others. The other choices (A, B, C) are incorrect because the Presbyterian Church, Salerno, and Jewish scholars were not specifically mentioned as the pioneers of public health nursing. The extract highlights the significant role of convent deaconesses in laying the foundation for modern public health nursing.

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