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. While working in a long-term care facility, the nurse notices that older residents take pleasure in telling stories about their earlier lives and reliving special events. The nurse recognizes this helps residents meet which level of Maslow's Hierarchy of needs?

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

Correct answer: D

Rationale: The act of telling stories and reliving special events by the older residents in the long-term care facility helps them achieve self-actualization. Self-actualization involves realizing personal potential, self-fulfillment, seeking personal growth, and reflecting on their lives and achievements, which aligns with the behavior observed by the nurse. Choices A, B, and C are incorrect because self-esteem is related to confidence and respect, love and belonging refer to social relationships and connections, and safety pertains to physical and psychological security, which are not directly addressed by the residents' behavior of storytelling and reliving special events.

3. 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.

4. In a unionized hospital, nurses receive compensatory pay for working holidays based on the hours worked with no extra compensation. Despite management refusing to consider changes to the compensatory pay system suggested by nurses during the annual employee satisfaction survey, a trend member listened to both parties and made non-legally binding recommendations. What is this type of settlement known as?

• A. Collective bargaining
• B. Mediation
• C. Grievance
• D. Binding arbitration

Correct answer: B

Rationale: Mediation involves a neutral third party who assists in resolving disputes by providing non-legally binding recommendations. In this scenario, the trend member acted as a mediator by listening to both nurses and management and offering suggestions without the authority to enforce them as a legally binding decision. Collective bargaining refers to negotiations between labor unions and employers to determine terms of employment. Grievance is a formal complaint by an employee against an employer. Binding arbitration involves a neutral third party making a final and legally binding decision to resolve a dispute.

5. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

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