Nokea
The role of the Clinical Nurse Leader (CNL) would include:
- A. diagnosing a patient with pneumonia and prescribing antibiotics.
- B. teaching members of a faith community how to avoid skin cancer and referring those with suspicious lesions.
- C. participating in the team who is investigating possible abuse of elderly persons by members of a gang known to sell illegal drugs.
- D. coordinating care of a patient admitted 4 days ago with stage IV heart failure and chronic bronchitis by revising care plan to include ambulation 50 feet with assistance.
Correct Answer: D
Rationale: The correct answer is D because the role of a Clinical Nurse Leader (CNL) involves coordinating and managing the care of patients. In this scenario, the CNL is revising the care plan for a patient with complex health issues, such as heart failure and chronic bronchitis, by incorporating specific interventions like ambulation with assistance. This aligns with the core responsibilities of a CNL, which include care coordination, implementation of evidence-based practice, and leadership in interdisciplinary teams.
Choice A is incorrect because nurses, including CNLs, do not have the authority to diagnose and prescribe medications, as this falls under the scope of practice of a physician or advanced practice nurse.
Choice B is incorrect because while health education and referral are important aspects of nursing practice, they are more aligned with the role of a community health nurse rather than a CNL.
Choice C is incorrect because investigating abuse and criminal activities is beyond the scope of a CNL's role, as their focus is primarily on
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An elderly person, age 80, is finding it difficult to live alone and the family is considering long-term care. The elderly person is reasonably healthy, with only normal aging declines, and maintains a healthy appetite. All medications are administered orally and require only minimal assistance. She is financially secure with an income based on retirement from both the military and factory from her deceased husband and herself. The family contacts long- term care and is told that, based on this patient's information:
- A. Medicare will cover the cost of stay since skilled services are required.
- B. Medicaid is only for families with dependent children.
- C. Medicare will pay for home health services should these additional services meet the needs of the individual.
- D. Medicare will pay regardless of household income or financial status for nursing home care.
Correct Answer: C
Rationale: Rationale for Correct Answer (C): Medicare will pay for home health services should these additional services meet the needs of the individual.
1. Medicare covers home health services for individuals who meet specific criteria, which may include being homebound, needing skilled nursing care, and having a care plan established by a healthcare provider.
2. In this scenario, the elderly person is reasonably healthy and only requires minimal assistance with oral medications, indicating that she may benefit from home health services rather than long-term care.
3. Since the elderly person is financially secure, it is likely that she does not meet the eligibility criteria for Medicaid, which is a need-based program for individuals with limited income and resources.
4. Medicare does not cover long-term care in a nursing home unless specific criteria are met, such as requiring skilled services on a short-term basis. In this case, the elderly person's need for assistance with oral medications does not necessarily qualify as a skilled service for nursing home care.
Summary of Incorrect Choices:
A
A peaceful death is best characterized by which terminally ill patient?
- A. One who is surrounded by family
- B. One who uses meditation to help manage pain
- C. One who has advanced directives in place
- D. One who has drifted from lethargy to coma
Correct Answer: A
Rationale: The correct answer is A because being surrounded by family provides emotional support, comfort, and a sense of closure. Family presence can alleviate fear, anxiety, and loneliness, contributing to a peaceful death experience. Choice B focuses on pain management but does not address emotional well-being. Choice C, while important for end-of-life care, does not directly impact the patient's immediate comfort. Choice D indicates a decline in consciousness, which may not necessarily lead to a peaceful death experience as the patient may not be aware of their surroundings or loved ones.
An RN recently relocated to another region of the country and immediately assumed the role of charge nurse. When determining the appropriate person to whom to delegate, the RN knows that:
- A. the role of the LPN/LVN is the same from state to state.
- B. the LPN/LVN can be taught to perform all the duties of an RN if approved by the employer and if additional on-the-job training is provided.
- C. he or she must review the state's nurse practice act for LPN/LVNs, because each state defines the role and scope of practice of the LPN/LVN.
- D. The Joint Commission has certified and established roles for the LPN/LVN.
Correct Answer: C
Rationale: The correct answer is C. When delegating tasks to an LPN/LVN, the RN must review the state's nurse practice act because each state defines the role and scope of practice of the LPN/LVN. This is crucial as the LPN/LVN scope of practice can vary significantly from state to state. By reviewing the nurse practice act, the RN ensures that the tasks being delegated fall within the legal scope of practice for the LPN/LVN in that specific state, promoting safe and effective patient care.
Choice A is incorrect because the role of the LPN/LVN can differ between states.
Choice B is incorrect because LPN/LVNs cannot perform all duties of an RN, and additional training does not change their scope of practice.
Choice D is incorrect because the Joint Commission does not establish roles for LPN/LVNs; it focuses on accreditation standards for healthcare organizations.
A nurse is having difficulty managing assignments at work, which results in a feeling of "failure" and tasks that are not completed or that are not completed satisfactorily. The mentor suggests some tips for time management. These include: (select all that apply)
- A. focusing on activities to be completed, rather than on objectives.
- B. planning for tomorrow today.
- C. making certain that the last hours are the most productive in tying up loose ends.
- D. maintaining a log of how the nurse spends time (no need to worry about using complete sentences).
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. Planning for tomorrow today allows the nurse to set clear goals and prioritize tasks in advance.
2. By planning ahead, the nurse can allocate time efficiently, reducing the feeling of overwhelm.
3. This approach fosters better organization and focus, enhancing productivity and task completion.
4. Planning helps in identifying potential obstacles and developing strategies to overcome them.
5. Ultimately, effective planning leads to better time management and a sense of accomplishment.
Summary of why other choices are incorrect:
A: Focusing on activities rather than objectives can lead to a lack of direction and prioritization.
C: Making the last hours most productive neglects the importance of consistent time management throughout the day.
D: Maintaining a log of time spent can be helpful but does not address the proactive approach of planning ahead for better time management.
An older adult is unable to reach the telephone and is found dead at home several hours later. The son of the deceased person arrives at the hospital and asks, "Can I just please stay and hold my dad's hand? He was so afraid of dying alone." Which response by the nurse shows empathy?
- A. "You are just too late for that. Where were you when he needed you?"
- B. "Did you ever consider purchasing a cell phone for your dad to prevent this from happening?"
- C. "I'll close the door so you can spend time with your dad. I will check back in a few minutes."
- D. "I lost my dad last year. He died alone. He was a policeman. I am just like you. Let me stay here and console you."
Correct Answer: C
Rationale: The correct answer is C because it demonstrates empathy by acknowledging the son's request and providing support. By closing the door to allow privacy and promising to check back, the nurse shows understanding and compassion for the son's emotional needs.
Choice A is incorrect as it is insensitive and blames the son. Choice B is inappropriate as it shifts the focus to purchasing a cell phone rather than addressing the son's emotional state. Choice D is also incorrect as it redirects the attention to the nurse's personal experience, failing to address the son's specific request.