Nursing Elites

1. In an underdeveloped country, the nurse observes the natives lighting ritual fires and pounding on primitive drums around the sick person to promote recovery. The nurse interprets this behavior as indicating the natives believe illness results from which items?

• A. Pathogens and genetics
• B. Evil spirits
• C. Tides and planets
• D. Plants and animals

Correct answer: B

Rationale: The behavior of lighting fires and pounding on drums to promote recovery suggests a belief in evil spirits causing illness. In many cultures, rituals like these are performed to ward off evil spirits or negative energies that are thought to be the cause of sickness. Choices A, C, and D are incorrect as the described behavior aligns more with spiritual or supernatural beliefs rather than scientific explanations related to pathogens, genetics, tides, planets, plants, or animals.

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. Which professional organization was the first to focus on licensed practical nurses (LPNs)?

• A. National Association for Practical Nurse Education and Services (NAPNES)
• B. National Federation of Licensed Practical Nurses (NFLPN)
• C. National League for Nursing (NLN)
• D. American Nurses Association (ANA)

Correct answer: A

Rationale: The National Association for Practical Nurse Education and Services (NAPNES) was the first professional organization to focus on LPNs. NAPNES remains active today, providing continuing education opportunities and publications specifically tailored for LPNs, making it the correct answer. The other options, the National Federation of Licensed Practical Nurses (NFLPN), National League for Nursing (NLN), and American Nurses Association (ANA), do not primarily focus on licensed practical nurses, making them incorrect choices.

4. 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.

5. Which action demonstrates a coparticipative manner in the nursing model of care?

• A. Working with the patient and family to achieve the best outcome.
• B. Encouraging the shy student to participate in class discussions, demonstrating transpersonal caring.
• C. Finding a way for a patient to see a dog, understanding the patient's needs.
• D. Accepting individuals for who they are, maintaining a nonjudgmental attitude.

Correct answer: A

Rationale: A coparticipative manner in the nursing model of care involves collaborating with the patient and family to achieve the best outcome. This approach emphasizes working together as a team to address healthcare needs and make decisions. While encouraging a shy student, understanding a patient's needs, and maintaining a nonjudgmental attitude are all important aspects of nursing care, the coparticipative manner specifically focuses on partnership and shared decision-making in the care process.

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