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. What is the primary focus of the Patient Protection and Affordable Care Act?

• A. Reducing the cost of healthcare
• B. Providing healthcare to undocumented immigrants
• C. Ensuring access to healthcare for all Americans
• D. Eliminating the need for health insurance

Correct answer: C

Rationale: The correct answer is C: Ensuring access to healthcare for all Americans. The primary focus of the Patient Protection and Affordable Care Act is to expand coverage, improve quality of care, and make healthcare more affordable and accessible to a greater number of people in the United States. Choice A is incorrect because while the act aims to make healthcare more affordable, its primary focus is on access. Choice B is incorrect as the act is not specifically designed to provide healthcare to undocumented immigrants. Choice D is incorrect as the act does not aim to eliminate the need for health insurance but rather improve the availability and affordability of insurance coverage.

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. Which action demonstrates a coparticipative manner in the nursing model of care?

• A. Working with the patient and family to achieve the best outcome.
• B. Encouraging the shy student to participate in class discussions, demonstrating transpersonal caring.
• C. Finding a way for a patient to see a dog, understanding the patient's needs.
• D. Accepting individuals for who they are, maintaining a nonjudgmental attitude.

Correct answer: A

Rationale: A coparticipative manner in the nursing model of care involves collaborating with the patient and family to achieve the best outcome. This approach emphasizes working together as a team to address healthcare needs and make decisions. While encouraging a shy student, understanding a patient's needs, and maintaining a nonjudgmental attitude are all important aspects of nursing care, the coparticipative manner specifically focuses on partnership and shared decision-making in the care process.

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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