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A nurse is very interested in learning more about health care economics and how she can use that knowledge to become a better patient advocate. She comments, "Nurses should not only deliver care one day at a time in one facility but should coordinate patient care as they move from acute care to rehabilitation to home care." This nurse would be a candidate for which nursing role?
- A. Disease management program (DMP) for chronic illnesses
- B. A hospital-based utilization management nurse who reviews medical records to determine the most appropriate DRG for patients
- C. Case management
- D. Reviewer for Managed Care Organization
Correct Answer: C
Rationale: Rationale:
1. The nurse's interest in coordinating patient care across different settings aligns with the role of a case manager.
2. Case managers focus on ensuring continuity of care and coordinating services for patients transitioning between different healthcare settings.
3. This role involves advocating for patients' needs and optimizing their health outcomes through seamless care transitions.
Summary:
A: DMP focuses on managing chronic illnesses, not coordinating care across settings.
B: Utilization management nurses focus on determining appropriate reimbursement levels, not on care coordination.
D: Reviewers for Managed Care Organizations focus on assessing medical necessity and cost-effectiveness, not on care coordination.
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A nurse is listening to a patient's apical heart rate. The patient asks, "Is everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is demonstrating:
- A. open communication.
- B. filtration.
- C. blocking.
- D. false assurance.
Correct Answer: D
Rationale: The correct answer is D: false assurance. By not providing a verbal response to the patient's question and shrugging her shoulders, the nurse is not giving any indication of the patient's actual condition. This lack of communication can lead the patient to interpret the nurse's actions as reassurance that everything is fine, which is a form of false assurance. This behavior can be misleading and may prevent the patient from receiving important information about their health status.
Incorrect choices:
A: open communication - The nurse's lack of verbal response and shrugging shoulders does not demonstrate open communication.
B: filtration - Filtration is not relevant to the situation described.
C: blocking - While the nurse is not providing necessary information, the term "blocking" does not accurately describe the situation.
A nurse is interested in understanding the meaning of the human experience of surviving polio. Subject recruitment targets persons who have been diagnosed with the disease. The researcher reflects on the data and identifies common themes in order to understand the "lived experience." These characteristics are consistent with the qualitative research method known as:
- A. grounded theory.
- B. ethnography.
- C. phenomenology.
- D. case study.
Correct Answer: C
Rationale: The correct answer is C: phenomenology. Phenomenology focuses on exploring and understanding individuals' lived experiences to uncover the essence of a phenomenon. In this case, the nurse is interested in understanding the meaning of surviving polio from the perspective of those diagnosed with the disease. By reflecting on the data and identifying common themes, the researcher aims to capture the essence of the human experience of surviving polio.
Grounded theory (A) is a method used to develop theories from data, not necessarily focusing on the lived experience. Ethnography (B) involves studying cultures and societies, which is not directly aligned with understanding individual experiences. Case study (D) typically focuses on in-depth analysis of a specific individual or group, rather than exploring common themes across individuals' experiences.
A nurse researcher who is seeking funding for a study should identify _ of funding agencies.
- A. board members
- B. priorities
- C. budgets
- D. accreditation
Correct Answer: B
Rationale: The correct answer is B: priorities. When seeking funding for a study, identifying the priorities of funding agencies is crucial as it helps align the research proposal with the agency's focus areas, increasing the chances of securing funding. Board members (A) are individuals overseeing the agency, not directly related to funding decisions. Budgets (C) refer to financial resources, which are important but secondary to understanding the agency's priorities. Accreditation (D) is about meeting certain standards and is not directly related to identifying funding agencies. Therefore, it is essential to focus on understanding the priorities of funding agencies when seeking funding for a study.
Patients with heart failure have extended lengths of stay and are often readmitted shortly after they have been discharged. To improve quality of care, a type of "road map" that included all elements of care for this disease and that standardized treatment by guiding daily care was implemented. This road map is referred to as a(n):
- A. benchmark.
- B. critical pathway.
- C. algorithm.
- D. case management.
Correct Answer: B
Rationale: The correct answer is B: critical pathway. Critical pathways are structured, multidisciplinary care plans that detail essential steps in the care of patients with specific conditions, such as heart failure. They standardize treatment by outlining the sequence and timing of interventions, tests, and medications, helping to improve efficiency and quality of care. Critical pathways guide daily care by providing a roadmap for healthcare providers to follow, ensuring that patients receive appropriate and timely interventions.
Explanation of other choices:
A: Benchmark - Benchmarks are standards or reference points used for comparison, not a structured care plan like a critical pathway.
C: Algorithm - Algorithms are step-by-step procedures for solving problems, not necessarily a comprehensive care plan like a critical pathway.
D: Case management - Case management involves coordinating care and services for individual patients, not a standardized care plan for a specific disease like a critical pathway.
An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision?
- A. There is no supervision, because at times the LPN/LVN is not with the RN.
- B. Periodic inspection is being used. Because the LPN/LVN is licensed, the RN is relieved of the need to evaluate care.
- C. Continual supervision is being provided until the RN determines competency.
- D. Initial supervision is being provided because this is the LPN/LVN's first day on the unit.
Correct Answer: C
Rationale: The correct answer is C: Continual supervision is being provided until the RN determines competency.
Rationale:
1. Continual supervision is necessary for the LPN/LVN on the first day to assess their competency.
2. The RN checks frequently throughout the shift to provide support and evaluate the LPN/LVN's performance.
3. Competency must be determined before reducing supervision levels.
4. This level of supervision ensures patient safety and quality care.
Incorrect choices:
A: There is no supervision - Incorrect because supervision is provided by the RN.
B: Periodic inspection - Incorrect as continual supervision is needed for competency assessment.
D: Initial supervision - Incorrect as supervision should continue until competency is established.
In summary, choice C is correct as continual supervision is crucial for the LPN/LVN on their first day to ensure patient safety and quality care.