Nursing Elites

1. Which title identifies a nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers?

• A. Team leader in nursing care delivery
• B. Case manager
• C. Nurse manager
• D. Coordinator of patient-centered care delivery

Correct answer: B

Rationale: The correct answer is B: Case manager. A case manager plays a crucial role in coordinating a patient's care across different healthcare settings and providers to ensure continuity, efficiency, and optimal outcomes. They work closely with various members of the healthcare team to facilitate a comprehensive care plan and address the patient's needs throughout their healthcare journey. Choice A is incorrect because a team leader in nursing care delivery focuses more on supervising a team of nurses rather than patient care coordination. Choice C, Nurse manager, typically oversees a nursing unit or department but may not have the primary role of coordinating a patient's care. Choice D, Coordinator of patient-centered care delivery, though related, does not specify the direct responsibility of following a patient from admission to discharge or resolution of illness.

2. 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.

3. The nurse is caring for a patient who has just received a cancer diagnosis. The patient is crying. The nurse recognizes this patient is operating on what level of Maslow's hierarchy of needs?

• A. Self-esteem
• B. Love and belonging
• C. Safety
• D. Self-actualization

Correct answer: C

Rationale: In Maslow's hierarchy of needs, safety needs come after physiological needs. When a patient is crying after receiving a cancer diagnosis, they may be feeling a lack of security and safety. This indicates that the patient is operating on the level of safety needs in Maslow's hierarchy. Choice A, self-esteem, focuses on confidence and respect, which is not the immediate concern when receiving a cancer diagnosis. Choice B, love and belonging, pertains to relationships and social connections, which are important but not the primary focus in this situation. Choice D, self-actualization, involves personal growth and fulfilling one's potential, which is a higher-level need compared to safety needs, making it less likely for a patient to be operating at this level when distressed by a cancer diagnosis.

4. 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.

5. How do accrediting agencies such as the Joint Commission ensure quality care?

• A. Imposing maximum staffing levels
• B. Stipulating nurse-patient ratios
• C. Confirming delivery of satisfactory care
• D. Requiring a specific staff mix

Correct answer: C

Rationale: Accrediting agencies such as the Joint Commission primarily focus on confirming the delivery of satisfactory care rather than imposing specific staffing levels, nurse-patient ratios, or staff mix. They do not dictate the exact staffing levels or ratios but rather evaluate if the care provided meets established quality standards. While adequate staffing levels and appropriate nurse-patient ratios are essential for quality care, accrediting agencies like the Joint Commission assess the outcomes and overall quality of care delivered by healthcare facilities.

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