Nursing Elites

1. What factor has had the greatest impact on the current nursing shortage?

• A. Later age at which women have children
• B. Decrease in the number of women being born
• C. Overall unemployment rate
• D. Increased employment options for women

Correct answer: D

Rationale: The correct answer is D. The increased employment options for women have had a significant impact on the current nursing shortage. With more career choices available to women, there is a decrease in the number of individuals pursuing nursing as a profession, contributing to the shortage. This is because women are choosing diverse career paths due to increased opportunities. Choices A, B, and C are incorrect. A later age at which women have children and the decrease in the number of women being born are not directly related to the nursing shortage. The overall unemployment rate, while influencing job availability, is not the primary factor driving the shortage of nurses.

2. 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.

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. A healthcare professional walks into the nurse's station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions should the healthcare professional take first?

• A. remind the staff members that this is a breach of confidentiality
• B. discuss the issue with the unit manager
• C. request that an administrative restriction be placed on the client's medical access
• D. prepare a report for the facility ethics committee

Correct answer: A

Rationale: The correct action for the healthcare professional to take first is to remind the staff members that accessing the electronic medical record of a celebrity client from another unit is a breach of confidentiality. This immediate action addresses the ethical and legal issue at hand, emphasizing the importance of patient confidentiality and privacy. Discussing the issue with the unit manager, requesting administrative restrictions, or preparing a report for the facility ethics committee can be considered after addressing the initial breach and reminding staff members of their obligations.

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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