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An RN has been assigned to care for three clients on the medical unit and will assume 24-hour accountability for those clients' care. When the nurse goes off duty, the plan of care will be continued by a secondary nurse. What type of nursing model is this considered?
- A. Team nursing
- B. Case method
- C. Functional nursing
- D. Primary care nursing
Correct Answer: D
Rationale: In primary care nursing, the RN assumes 24-hour accountability for the client's care and has total responsibility for the nursing care of assigned clients during a shift. Team nursing is made up of an RN team leader, other RNs, LPN/LVNs, and nursing assistants who provide care to a group of clients. The case method is the same as a private duty nurse. In functional nursing, distinct duties are assigned to specific personnel.
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Which of the following describes the goal of alternative care facilities?
- A. An RN and one or more assistive personnel care for a group of clients.
- B. An RN assumes all care for a small group of clients.
- C. There is 24-hour accountability by an RN.
- D. The facility provides the least restrictive living arrangement.
Correct Answer: D
Rationale: The goal of alternative care facilities is to provide the least restrictive living arrangement while maintaining safety and quality. Patient-focused care uses an RN partnered with one or more assistive personnel to care for a group of clients. Total care refers to assignments in which a nurse assumes all the care for a small group of clients. In primary nursing, an RN assumes 24-hour accountability for the client's care and has total responsibility for the nursing care of assigned clients during the shift.
A client who is receiving respiratory support with a tracheostomy and mechanical ventilation after a stroke is being discharged from the acute care facility. Family members state that they will not be able to care for the client at home to provide the care that is required. What type of care may this client be a candidate for after discharge?
- A. Long-term acute care
- B. Subacute care
- C. Intermediate care facility
- D. Rehabilitation care
Correct Answer: A
Rationale: Clients who require ventilator support or who have other conditions that are potentially unstable but do not have rapid changes may receive care in a long-term acute care facility. Subacute care refers to care that is more intense than traditional long-term care but less intense than acute inpatient care. Intermediate care facilities (ICFs) are nursing homes that provide custodial care for people who cannot care for themselves because of mental or physical disabilities. Rehabilitation centers provide physical and occupational therapy to clients and families to help individuals regain as much independence with ADLs as possible.
The charge nurse is making assignments for a group of clients on a medical unit. When reviewing the acuity of the clients, the charge nurse assigns the RN to the clients with higher acuity levels. Why would the charge nurse assign the RN to the clients with a higher acuity?
- A. LPNs do not understand how to care for clients with complex disorders.
- B. Assigning an LPN would allow them to provide care out of their scope of practice.
- C. Higher acuity clients may request the services of an RN versus other care providers.
- D. A higher acuity client requires a greater need for highly skilled care.
Correct Answer: D
Rationale: Generally, higher acuity requires a greater need for highly skilled care. Clients with complicated or high-risk surgery, massive trauma, or critical illness will be cared for in an acute care hospital, where a high level of professional, skilled, and technological care is available. RNs are instrumental in caring for these clients. LPNs may understand how to care for clients with complex disorders, but RNs are instrumental in the client care. Clients generally do not request care by a specific provider; nurses with different levels of education perform various care activities.
Which nursing theorist stated that clients are open systems in constant interaction with their environment?
- A. Florence Nightingale
- B. Virginia Henderson
- C. Imogene King
- D. Dorothea Orem
Correct Answer: C
Rationale: Imogene King stated that clients are open systems in constant interaction with their environment. Florence Nightingale described the role of the nurse as putting 'the patient in the best condition for nature to act upon him.' Virginia Henderson envisioned the nurse's role as helping people (sick or well) to carry out activities contributing to health, recovery, or a peaceful death that they would do for themselves if they had the necessary strength, will, or knowledge. Dorothea Orem was a proponent of the self-care deficit theory.
The LPN is part of a group of nurses that has an RN team leader as well as another LPN and two nursing assistants who will be providing care to a group of clients. What type of nursing method is this considered?
- A. Functional nursing
- B. Total client care
- C. Case method
- D. Team nursing
Correct Answer: D
Rationale: Team nursing is composed of an RN team leader, other RNs, LPN/LVNs, and nursing assistants who provide care to a group of clients. Functional nursing is a task-oriented method where everyone in the group is assigned to specific tasks. Case method is the same as private duty nursing. Total client care refers to assignments in which a nurse assumes all the care for a small group of clients.