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. 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 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.

4. On what are most nursing paradigms based?

• A. The nurse's ability to perform procedures with skill
• B. Dr. Jean Watson's transpersonal caring theory
• C. Maslow's theory of hierarchy of needs
• D. Learning by studying nursing theories and clinical experiences

Correct answer: D

Rationale: Most nursing paradigms are founded on the understanding and application of nursing theories through studying them and gaining practical experiences in clinical settings. While the nurse's ability to perform procedures with skill is important, it is not the foundation of nursing paradigms. Dr. Jean Watson's transpersonal caring theory and Maslow's theory of hierarchy of needs are significant in nursing practice but do not serve as the basis for most nursing paradigms. Nursing paradigms are shaped by a combination of studying nursing theories and hands-on clinical experiences, which provide the foundational knowledge and practical skills needed for nursing practice.

5. The educator is teaching a group about paradigm thinking and defines it as what?

• A. One's mathematical knowledge and ability to solve math problems
• B. The ability to see 20 feet away without wearing glasses
• C. An individual's perception or frame of reference about the world
• D. A healthcare provider's ability to solve patient-care problems

Correct answer: C

Rationale: Paradigm thinking refers to an individual's perception or frame of reference about the world. It involves understanding how one sees and interprets the world around them, which can influence their beliefs, decisions, and actions. Choices A, B, and D are incorrect as they do not accurately describe paradigm thinking. Paradigm thinking is not solely related to mathematical knowledge, eyesight, or healthcare problem-solving skills.

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