Nursing Elites

1. What theme of critical thinking is demonstrated when an individual decides to return to school to obtain a bachelor of science degree in nursing?

• A. Critical thinking involves both productive and positive activities.
• B. Critical thinking is a process, not an outcome.
• C. Manifestations of critical thinking vary based on the context in which they occur.
• D. Critical thinking is triggered by both positive and negative events.

Correct answer: D

Rationale: The decision to return to school to obtain a bachelor of science degree in nursing can be triggered by various factors, both positive (like a desire for career advancement) and negative (like feeling limited without the degree). This decision reflects critical thinking as it involves a thoughtful evaluation of personal and professional goals, weighing potential benefits and consequences. Therefore, the theme of critical thinking demonstrated in this scenario is that critical thinking is triggered by both positive and negative events. Choices A, B, and C are incorrect because they do not specifically address the concept of critical thinking being influenced by positive and negative events as demonstrated in the scenario.

2. 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.

3. When the nurse receives a shift report from the nurse going off shift and asks about a patient's state of mind and emotional needs, which aspect of Dr. Watson's theory is demonstrated?

• A. Intentionality
• B. Curiosity
• C. Caritas
• D. Holism

Correct answer: C

Rationale: The correct answer is C: Caritas. The act of inquiring about a patient's state of mind and emotional needs reflects the concept of Caritas in Dr. Watson's theory. Caritas involves showing deep concern, compassion, and love for the patient, going beyond just the physical aspects of care. Choice A, Intentionality, refers to the capacity for nurses to act deliberately with an ultimate goal in mind. Choice B, Curiosity, is not directly related to the specific action described in the question. Choice D, Holism, involves considering the patient as a whole being, including physical, emotional, social, and spiritual aspects, but it is not specifically demonstrated by inquiring about emotional needs and state of mind.

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. While supervising the care of several clients, which action requires intervention by the charge nurse?

• A. A nurse photocopies a client's diagnostic test results.
• B. An assistive personnel documents the client's vital signs on the client's paper-based graphic record.
• C. The unit secretary faxes a client's laboratory results to the provider.
• D. An RN stays with a client to discuss her understanding of her vital signs that were requested.

Correct answer: A

Rationale: The charge nurse should intervene when a nurse photocopies a client's diagnostic test results as it violates patient confidentiality and privacy. This action breaches HIPAA regulations, and sensitive patient information should not be photocopied without proper authorization. The other actions are within the scope of practice and do not raise concerns regarding patient privacy or confidentiality.

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