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A patient is admitted for a hysterectomy, and the RN develops and implements the plan of care but also delegates to the LPN/LVN the responsibility of administering oral medications. While off duty, this RN receives a call requesting a change in the plan of care because the patient has developed deep vein thrombosis. The nurse who originally planned the care is practicing which type of nursing care delivery?
- A. Modular
- B. Primary
- C. Team
- D. Functional
Correct Answer: B
Rationale: The correct answer is B: Primary nursing care delivery. In primary nursing, one nurse assumes 24-hour responsibility for planning, implementing, and evaluating the care of a patient. In this scenario, the RN developed and implemented the plan of care and delegated specific tasks to the LPN/LVN. The RN remains responsible for the overall care even while off duty, as evidenced by receiving a call regarding a change in the plan of care. The other choices are incorrect because:
A: Modular nursing involves a team of healthcare providers working together, sharing responsibilities, and providing care collectively.
C: Team nursing involves a team of healthcare providers with different levels of expertise working collaboratively to deliver patient care.
D: Functional nursing divides tasks among different team members based on their skill sets, which is not the case in the scenario provided.
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An Asian teenager is admitted with an eating disorder which she contributes to by not meeting the academic expectations of her parents. The nurse is overheard saying, "That isn't the reason; all Asians are really smart." This nurse is demonstrating:
- A. cultural humility.
- B. stereotyping.
- C. cultural assimilation.
- D. acculturation.
Correct Answer: B
Rationale: The correct answer is B: stereotyping. The nurse is making a generalization about an entire group based on a perceived characteristic. This statement is not only inaccurate but also perpetuates harmful stereotypes. Cultural humility (A) involves recognizing and respecting the differences and complexities of various cultures. Cultural assimilation (C) refers to adopting the cultural norms of a dominant group, which is not applicable in this scenario. Acculturation (D) is the process of adapting to a new culture, which is also not relevant to the nurse's statement. Stereotyping is the most appropriate choice as it directly addresses the nurse's biased and inaccurate assumption about intelligence based on race.
A nurse realizes that much time is wasted during shift report when coworkers discuss personal items such as recent movies or department store sales. Which statement would help with time management during this critical interaction?
- A. "Let's talk only about one movie you recently watched."
- B. "I like to know about department store sales, but we need to get through this report, so let's talk about sales as we walk between patient rooms."
- C. "I know your shift has been busy. What went wrong?"
- D. "I have the list of patients; let's start with revisions to the plan of care and scheduled activities for the next shift."
Correct Answer: D
Rationale: The correct answer is D because it directly addresses the issue of time management during shift report by focusing on the essential tasks that need to be discussed. By starting with revisions to the plan of care and scheduled activities for the next shift, the nurse ensures that the most critical information is covered efficiently. This approach helps prioritize the discussion and prevent unnecessary time spent on non-essential topics.
Option A is incorrect because limiting the discussion to just one movie does not address the overall time management issue during shift report. Option B is incorrect because discussing department store sales while walking between patient rooms may still lead to distractions and inefficiencies in the report.
Option C is incorrect as it focuses on what went wrong during the shift rather than addressing the need for efficient time management during the report. The correct answer, D, is the most effective choice as it directly tackles the issue of time wasted during shift report by emphasizing the essential tasks that need to be covered.
A new graduate nurse is preparing for an interview for her first position and knows that: (select all that apply)
- A. the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school.
- B. appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position.
- C. self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners.
- D. work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio.
Correct Answer: A
Rationale: The correct answer is A because the primary goal for a new graduate nurse in their first job is to successfully complete the orientation process. This is crucial for transitioning from the academic setting to the professional nursing environment. Completing orientation ensures that the nurse is equipped with the necessary knowledge and skills to provide safe and effective patient care.
Choice B is incorrect because scheduling interviews immediately after graduation may not allow the nurse enough time to prepare adequately for the interview process.
Choice C is incorrect because while self-confidence is important, relying solely on past achievements of peers may not be a sustainable source of confidence in a new work environment.
Choice D is incorrect because while work history and letters of recommendation can be valuable, they may not necessarily be the primary focus during the initial stages of a new nurse's career.
A client is hypertensive, and the doctor prescribes weight reduction. The client is excited about beginning the diet, but on arriving home the spouse states, "You have always been fat, and I am not going to starve because you can't control yourself." The client becomes anxious and is unable to participate in the diet plan, resulting in a weight gain of 5 pounds in 2 weeks. Which theorist could best be referred to for guidance regarding interventions in this situation?
- A. Martha E. Rogers
- B. Hildegard E. Peplau
- C. Florence Nightingale
- D. Myra Estrin Levine
Correct Answer: B
Rationale: The correct answer is B: Hildegard E. Peplau. Peplau's nursing theory focuses on interpersonal relations, emphasizing the nurse-client relationship. In this situation, the client's anxiety and inability to participate in the diet plan are directly related to the negative interaction with the spouse. Peplau's theory suggests that the nurse can intervene by providing emotional support, facilitating communication, and helping the client manage anxiety. Rogers' theory focuses on the science of unitary human beings, which is not directly applicable here. Nightingale's theory emphasizes environmental factors, not interpersonal relationships. Levine's theory focuses on conservation principles, which are not directly relevant to addressing the client's anxiety and relational issues. Therefore, Peplau's theory best guides interventions in this situation.
The Affordable Care Act of 2011:
- A. requires that by 2020 all newly licensed nurses have a bachelor's degree at minimum.
- B. would provide health care benefits to millions who were previously uninsurable or unable to afford insurance.
- C. caps the amount that hospitals and physicians can charge for procedures.
- D. subsidizes private insurance companies, thereby reducing health care costs for individuals who have chronic or catastrophic illness such as cancer.
Correct Answer: B
Rationale: The correct answer is B because the Affordable Care Act of 2011 aimed to provide health care benefits to millions who were previously uninsurable or unable to afford insurance. This is in line with the main goal of the act, which was to increase access to affordable health care for Americans. Choice A is incorrect as the act does not mandate educational requirements for nurses. Choice C is incorrect as the act does not specifically cap the amount that hospitals and physicians can charge for procedures. Choice D is incorrect as the act focuses on expanding access to health insurance rather than directly subsidizing private insurance companies to reduce costs for individuals with chronic illnesses.