Nursing Elites

1. Which statement about the U.S. healthcare system made by the nurse is untrue and inaccurate?

• A. There is no central agency governing the healthcare system.
• B. Access to healthcare is available to all persons regardless of ability to pay.
• C. Legal risk must be considered when providing healthcare.
• D. High-tech equipment is available but payment for its use is troublesome to the system.

Correct answer: B

Rationale: The correct answer is B. Access to healthcare is not universally available to all persons in the U.S.; it is often influenced by the ability to pay. Choice A is accurate as there is no single central agency governing the entire U.S. healthcare system. Choice C is a valid consideration as legal risks are important in healthcare provision. Choice D highlights a common issue in the U.S. healthcare system where high-tech equipment is available, but the payment for its use can be problematic.

2. The nurse is caring for a patient transferred from the local prison who was arrested and convicted of child sexual abuse. The nurse feels disgust for the patient's behavior but can avoid being judgmental by understanding what?

• A. Motivation
• B. State laws
• C. The patient's social history
• D. Code of ethics

Correct answer: A

Rationale: In this scenario, the nurse is experiencing negative emotions towards the patient's behavior. By understanding the patient's motivation, the nurse can gain insight into the underlying factors that led to the behavior, helping to avoid being judgmental. This approach allows the nurse to provide care and support without letting personal feelings interfere. Understanding motivation can also aid in developing a therapeutic relationship and providing appropriate care tailored to the patient's needs. Choices B, C, and D are incorrect as while state laws, the patient's social history, and the code of ethics are important aspects to consider in healthcare, they do not directly address the nurse's feelings of disgust and the need to avoid being judgmental towards the patient's behavior.

3. 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.

4. The healthcare provider responds to an alarm on a pulse oximeter and sees that the patient's oxygen saturation is reading 38%. The provider observes the patient, noting a respiratory rate of 12 breaths per minute, pink mucous membranes, and easy regular respirations. The healthcare provider concludes that the pulse oximeter is not reading accurately. Whose theory of healthcare is this provider demonstrating?

• A. Annie Goodrich
• B. Lillian D. Wald
• C. Florence Nightingale
• D. Linda Richards

Correct answer: C

Rationale: Florence Nightingale emphasized the importance of assessing the patient's overall condition and not solely relying on technological readings. In this scenario, the healthcare provider's observation of the patient's respiratory rate, mucous membranes, and breathing pattern aligns with Nightingale's holistic approach to patient care. Annie Goodrich is known for her contributions to nursing education; Lillian D. Wald is associated with public health nursing and social reform; Linda Richards is recognized as America's first trained nurse. However, in this context, the emphasis is on the holistic patient assessment, which is a key principle of Florence Nightingale's theory.

5. A group of workers wish to seek union representation that would protect all workers in the agency, including unlicensed assistive personnel and non-nursing employees such as a nutritionist and dietary workers. The type of union being sought is the strongest collective group and is known by what term?

• A. A right-to-work bargaining organization
• B. An occupational union
• C. Industrial unionism
• D. Union shop

Correct answer: C

Rationale: Industrial unionism refers to a union that represents all workers in a particular industry, regardless of their specific job roles. In this scenario, the workers are looking for a union that covers a wide range of employees in the agency, making industrial unionism the most suitable option. Choice A, 'A right-to-work bargaining organization,' is incorrect as right-to-work laws pertain to union security agreements and do not define the type of union being sought. Choice B, 'An occupational union,' is incorrect as it typically represents workers within a specific occupation, not across various roles as described in the scenario. Choice D, 'Union shop,' is incorrect as it refers to a workplace where employees are required to join or pay union dues as a condition of employment, which is different from the scenario described.

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