Nursing Elites

1. 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.

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. Caring means responding to others as unique individuals, sensing their emotions, and accepting them as they are, unconditionally. This response accepts the patient's choice without condemning or frightening them.

• A. Finding a way for the patient to see the dog, even if they can only look out a window, shows caring by understanding this patient's needs.
• B. The definition of transpersonal caring includes accepting individuals for who they are, so a nonjudgmental attitude is essential.
• C. This statement includes the patient in planning care, demonstrating care for the patient's needs and preferences.
• D. Curative nursing care is high-tech, or nursing care that is based on the medical model of care, which often is based on the use of technology.

Correct answer: C

Rationale: The statement in option C aligns with the concept of caring described in the question. By including the patient in planning care, it demonstrates an understanding of and respect for the patient's individual needs and preferences. This approach fosters a patient-centered care environment, promoting better outcomes and patient satisfaction. Options A and B touch on aspects of caring but do not directly address the scenario described in the question. Option D introduces a different concept, curative nursing care, which is not relevant to the context of the question focused on patient-centered caring and acceptance.

4. When considering factors like high risk for falls, infection protocols, and special communication needs to determine the mix and number of staff needed on a telemetry unit, what is being utilized?

• A. diagnostic related groups
• B. clinical pathways
• C. case management
• D. Patient classification system

Correct answer: D

Rationale: In this scenario, the nurse is using a Patient Classification System, which helps in determining the appropriate staffing levels based on the acuity and care requirements of the patients in the telemetry unit. By considering factors like high risk for falls, infection protocols, and special communication needs, the nurse can allocate the right mix and number of staff to provide safe and effective care. The other choices are incorrect because diagnostic related groups are used for billing purposes, clinical pathways are standard care plans for specific diagnoses, and case management involves coordinating care and services for patients.

5. How can a healthcare provider best address the spiritual aspect of caring for a patient?

• A. Explain the patient's spiritual beliefs to the healthcare provider.
• B. Ask the patient to share their spiritual beliefs.
• C. Ask what the patient requires to meet their spiritual needs.
• D. Consult with a spiritual leader to understand the patient's spiritual needs.

Correct answer: C

Rationale: The most effective way for a healthcare provider to address the spiritual aspect of caring for a patient is by asking what the patient requires to meet their spiritual needs. This approach respects the patient's autonomy, acknowledges their individual beliefs, and allows for personalized and patient-centered care. Choice A is incorrect as it focuses on the healthcare provider's understanding rather than the patient's needs. Choice B could be invasive and may not be necessary to provide adequate spiritual care. Choice D involves consulting a spiritual leader, which may not always align with the patient's personal beliefs and preferences.

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