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. 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. Which role is not appropriate for the LPN to participate in?

• A. Administering medications
• B. Dressing changes
• C. Designing a research study
• D. Reporting patient changes

Correct answer: C

Rationale: The correct answer is C. Designing a research study is not typically within the scope of practice for a Licensed Practical Nurse (LPN). LPNs are primarily involved in providing direct patient care, such as administering medications, performing dressing changes, and reporting patient changes. Designing research studies usually requires advanced education and training beyond what an LPN receives, making it an inappropriate role for an LPN to participate in.

4. Medicaid, which is financed by what part of the government, is jointly funded by which two entities?

• A. State
• B. Federal
• C. County
• D. State and federal

Correct answer: D

Rationale: Medicaid is a healthcare program jointly funded by the state and federal governments. States have flexibility in administering Medicaid while adhering to federal guidelines, and both entities contribute funding to support the program. Choice A (State) is incorrect as Medicaid is not solely funded by the state government. Choice B (Federal) is not the only funding source for Medicaid. Choice C (County) is not a primary entity involved in financing Medicaid, making it incorrect. The correct answer is D, as Medicaid receives funding from both the state and federal governments.

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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