Nursing Elites

1. Which historical figure is honored for working to improve care for the mentally ill?

• A. Clara Barton
• B. Florence Nightingale
• C. Dorothea Dix
• D. Lillian D. Wald

Correct answer: C

Rationale: Dorothea Dix is the correct answer. She is recognized for her significant contributions in advocating for the improvement of care for the mentally ill. Dorothea Dix played a crucial role in transforming the way individuals with mental illnesses were treated, advocating for better living conditions and appropriate care. Her efforts led to improved standards and treatment practices for the mentally ill. Clara Barton is known for her role in founding the American Red Cross, Florence Nightingale is renowned as a pioneer in modern nursing, and Lillian D. Wald is recognized for her work in public health and social reform, but they are not specifically honored for their work in improving care for the mentally ill.

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. How does the high degree of professionalism among nurses impact their willingness to engage in organized strikes?

• A. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession
• B. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization
• C. Nurses who strike can be legally punished for abandonment and negligence considered to be professional misconduct
• D. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client's safety initiatives

Correct answer: A

Rationale: The correct answer is A. The high level of professionalism among nurses, as recognized in Gallup polls, often leads them to perceive organized strikes as conflicting with their duty to care for patients and uphold their professional standards. This conflict of interest can cause nurses to be hesitant or reluctant to participate in strikes. Choice B is incorrect because nurses' decision to engage in strikes is more influenced by professional values and patient care rather than evidence-based studies on management and labor views. Choice C is incorrect because while legal consequences may be a concern, the primary factor influencing nurses' decision on strikes is their professional commitment to patient care. Choice D is incorrect as nurses' focus during strikes is more on advocating for patient safety rather than emphasizing safety initiatives.

4. 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.

5. 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.

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