Nursing Elites

1. 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.

2. 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.

3. What is the difference between mediation and binding arbitration based on the statement provided?

• A. Mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor
• B. Mediation uses a trained person to facilitate negotiations without making a final decision
• C. Binding arbitration is a formal process where an arbitrator's decision is final and must be adhered to by both parties
• D. Binding arbitration requires both labor and management to engage in discussions to find the least harmful resolution

Correct answer: C

Rationale: The key difference between mediation and binding arbitration lies in the finality of the decision. In binding arbitration, the arbitrator's decision is ultimate, and both parties are obligated to comply with it. This differs from mediation, where a neutral third party facilitates negotiations but does not make a final decision. Choice A is incorrect as mediation is not necessarily sanctioned by the NLRB; it can be conducted independently. Choice B is incorrect because mediation does not involve a final decision-maker but focuses on facilitating discussions. Choice D is incorrect as binding arbitration does not aim to find the least harmful resolution but rather a final and binding decision by the arbitrator.

4. A group of local volunteers has completed an emergency response course and is able to assist with the triage of injured citizens. They also participate in local health fairs to teach residents how to react during tornadoes. The responders are members of what organization?

• A. Metropolitan Medical Response System (MMRS)
• B. Medical Reserve Corps (MRC)
• C. National Disaster Medical System (NDMS)
• D. Commissioned Corps Readiness Force (CCRF)

Correct answer: B

Rationale: The Medical Reserve Corps (MRC) is the correct answer. This group consists of local volunteers who have completed emergency response training and are able to assist in the triage of injured citizens. Additionally, they participate in local health fairs to educate residents on tornado response procedures. The other choices are incorrect: MMRS (Metropolitan Medical Response System) focuses on coordinating resources for mass casualty incidents, NDMS (National Disaster Medical System) is a federally coordinated system for medical response during disasters, and CCRF (Commissioned Corps Readiness Force) is part of a specific governmental service branch.

5. 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.

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