Nursing Elites

1. The increasing use of licensed practical nurses (LPNs) in management positions, especially in long-term care facilities, is an example of what?

• A. Assertive management
• B. A shifting paradigm
• C. Critical thinking
• D. Smarter LPN graduates

Correct answer: B

Rationale: The correct answer is B: A shifting paradigm. The increasing use of LPNs in management positions, particularly in long-term care facilities, represents a changing paradigm in healthcare management. This shift indicates a move towards assigning leadership responsibilities to LPNs, signaling a departure from traditional industry roles. Choices A, C, and D are incorrect because the situation described does not primarily demonstrate assertive management, critical thinking, or the intelligence of LPN graduates. The focus is on the evolving role of LPNs in management, suggesting a broader change in healthcare practices.

2. What may the patient's statement, 'I cannot read until I get my glasses,' indicate?

• A. The patient is embarrassed about needing glasses
• B. The patient has visual impairment
• C. The patient may be illiterate
• D. The patient is being uncooperative

Correct answer: C

Rationale: The patient stating they cannot read until they get their glasses suggests a potential issue with literacy rather than visual impairment or unwillingness to cooperate. This statement should prompt further assessment to determine the patient's reading abilities and potential literacy needs. Choice A is incorrect as the statement does not directly imply embarrassment. Choice B is incorrect as the statement does not necessarily indicate a visual impairment. Choice D is incorrect as there is no clear evidence of the patient being uncooperative based on the provided statement.

3. To form a core support group of nurses, where should the nurse organizer conduct meetings to gather initial information?

• A. Away from the work site with a group of managers to learn both sides of the situation
• B. In homes or local businesses with staff nurses
• C. At the facility to discuss nursing concerns
• D. At the work site with staff nurses who are respected leaders

Correct answer: B

Rationale: The correct approach is to conduct meetings in homes or local businesses with staff nurses. This location ensures confidentiality, prevents management influence, and allows the focus to be on gathering support for forming a core support group. Choice A is incorrect as involving managers may compromise the independence and authenticity of the group. Choice C is incorrect as conducting meetings at the facility may not provide a secure and unbiased environment for open discussions. Choice D is incorrect because holding meetings at the work site with respected leaders may lead to biased opinions and hinder open communication.

4. Which patient would be appropriately transferred to an assisted living facility?

• A. The patient requiring ongoing skilled nursing observation
• B. The patient who has recovered enough to return to work and daily life
• C. The child who was burned in a fire after losing both parents to the tragedy
• D. The patient who needs minimal assistance in performing activities of daily living but cannot live alone

Correct answer: D

Rationale: The correct answer is D. Patients suitable for transfer to assisted living facilities are those who require minimal assistance with activities of daily living but do not need constant skilled nursing observation. Option D aligns with the purpose of an assisted living facility, which provides support for individuals who can no longer live independently but do not require intensive medical care. Choices A, B, and C are incorrect because patients requiring ongoing skilled nursing observation, those who have recovered enough to return to work and daily life, and children who have experienced a traumatic event such as a fire are not typically candidates for assisted living facilities.

5. When caring for a patient who just received a terminal diagnosis and is tearful and frightened, what is the best action to demonstrate caring?

• A. Call the patient's spiritual leader to talk to the patient.
• B. Call the patient's family and ask them to come sit with the patient.
• C. Cry with the patient while sympathizing with their situation.
• D. Sit with the patient and listen to their fears.

Correct answer: D

Rationale: In situations where a patient receives a terminal diagnosis and is emotionally distressed, it is essential to provide empathy and support. Sitting with the patient and actively listening to their fears allows the patient to express their emotions and concerns. This action demonstrates genuine care and compassion, showing the patient that their feelings are acknowledged and valued. It creates a therapeutic environment that fosters trust and emotional well-being, helping the patient cope with the distressing news. Calling the patient's spiritual leader (Choice A) may not address the immediate emotional needs of the patient. Calling the patient's family (Choice B) can be comforting but might not directly address the patient's fears. Crying with the patient (Choice C) can blur professional boundaries and may not be as beneficial as actively listening and providing support.

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