Nursing Elites

1. Why is critical thinking necessary for identifying and understanding paradigms that exist in nursing practice?

• A. Critical thinking allows for the nurse to make superficial decisions.
• B. Critical thinking allows the nurse to thoroughly examine situations and issues.
• C. Critical thinking provides the nurse with quick answers.
• D. Critical thinking allows the nurse to accept information without needing to check its validity.

Correct answer: B

Rationale: Critical thinking is essential for nurses to identify and understand paradigms in nursing practice because it enables them to thoroughly examine complex situations and issues. By critically analyzing information and considering various perspectives, nurses can gain a deeper understanding of the underlying paradigms that shape nursing practice. This thorough examination helps nurses make informed decisions and provide high-quality care to patients. Choice A is incorrect because critical thinking involves deeper analysis, not superficial decisions. Choice C is incorrect because critical thinking does not provide quick answers; it involves a systematic and thoughtful approach. Choice D is incorrect because critical thinking encourages nurses to question information and verify its validity rather than accepting it blindly.

2. While working in a long-term care facility, the nurse notices that older residents take pleasure in telling stories about their earlier lives and reliving special events. The nurse recognizes this helps residents meet which level of Maslow's Hierarchy of needs?

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

Correct answer: D

Rationale: The act of telling stories and reliving special events by the older residents in the long-term care facility helps them achieve self-actualization. Self-actualization involves realizing personal potential, self-fulfillment, seeking personal growth, and reflecting on their lives and achievements, which aligns with the behavior observed by the nurse. Choices A, B, and C are incorrect because self-esteem is related to confidence and respect, love and belonging refer to social relationships and connections, and safety pertains to physical and psychological security, which are not directly addressed by the residents' behavior of storytelling and reliving special events.

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. If a nurse accepts the role of charge nurse on the evening shift, what effect will unionization have on the nurse's new position?

• A. The nurse can file a grievance that will be arbitrated automatically by the Union
• B. Charge nurse is part of the management team, so Union participation would be a conflict of interest
• C. The nurse is not eligible for collective bargaining activities dealing with unfair labor practices
• D. The nurse can be represented by the union because charge nurses are not considered part of the management team

Correct answer: B

Rationale: Choosing answer B is correct because charge nurses are typically considered part of the management team. As part of the management team, the charge nurse has decision-making responsibilities that align with the interests of the organization. Therefore, participating in a union would create a conflict of interest. Options A, C, and D are incorrect. Option A is incorrect because union arbitration is not typically applicable to management positions. Option C is incorrect because charge nurses, as part of the management team, would not be eligible for collective bargaining activities like frontline staff. Option D is incorrect because charge nurses, due to their managerial responsibilities, are generally not represented by unions for collective bargaining purposes.

5. Where do many people get medical insurance from?

• A. The primary care physician
• B. The local clinic
• C. Social security office
• D. The employer

Correct answer: D

Rationale: Many people obtain medical insurance through their employer. This is a common practice where employers offer health insurance benefits to their employees as part of their employment package. Choice A, primary care physician, is incorrect as they provide medical care, not insurance. Choice B, the local clinic, is incorrect as clinics offer medical services, not insurance. Choice C, social security office, is incorrect as it is not a typical source for obtaining medical insurance.

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