Nokea
Which of the following situations would be appropriate for the supervisory level of initial direction and/or periodic inspection?
- A. Experienced RNs work together to provide care for a group of patients newly diagnosed with meningitis.
- B. The RN assigns the LPN tasks within her scope of practice and checks back during the shift to ensure the tasks are completed correctly.
- C. A new graduate nurse is assigned care to a male patient with a hematocrit of 11.0 g of hemoglobin per deciliter and is receiving a blood transfusion. The charge nurse checks on the patient status every 15 to 30 minutes and asks the graduate to explain "next steps."
- D. No supervision is necessary since both are registered nurses.
Correct Answer: B
Rationale: The correct answer is B because the scenario describes a situation appropriate for the supervisory level of initial direction and periodic inspection. The RN assigning tasks to the LPN within her scope of practice and checking back ensures tasks are completed correctly, aligning with the supervisory role. This level of oversight is necessary for safe and effective patient care.
Choice A is incorrect as experienced RNs working together do not require supervisory direction for caring for patients. Choice C involves the charge nurse providing frequent oversight to a new graduate nurse, which is more than just periodic inspection. Choice D is incorrect because regardless of both being registered nurses, supervision may still be necessary, especially when assigning tasks to a different level of healthcare provider like an LPN.
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Which statement is true regarding health care for minorities?
- A. Federal legislation that provides free health insurance for minorities has resulted in fewer minorities than members of the general population who lack health insurance.
- B. Higher costs of health care coupled with lower wages for minorities have prevented most minorities from seeking health care.
- C. Because many Mexican Americans are highly skilled workers with comparable wages, they have the lowest uninsured rate.
- D. Asians, because of their quiet demeanor and unwillingness to challenge the health care system, have the highest rate of uninsured people.
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct:
1. Federal legislation such as the Affordable Care Act has expanded Medicaid coverage and provided subsidies for health insurance.
2. This legislation has helped reduce the number of minorities lacking health insurance.
3. Consequently, fewer minorities than members of the general population now lack health insurance.
4. Therefore, the statement that federal legislation has resulted in fewer minorities lacking health insurance is true.
Summary of why other choices are incorrect:
B. This choice incorrectly attributes the lack of seeking health care by minorities solely to higher costs and lower wages, overlooking the impact of legislation.
C. This choice makes a sweeping generalization about Mexican Americans without considering the broader context of health care access for minorities.
D. This choice relies on stereotypes about Asians and does not take into account the complexities of the health care system and insurance coverage.
Which nursing model is referred to as the "class without walls"?
- A. Articulation
- B. Career ladder (2 +
- C. Nightingale’s Environmental Nursing Theory
- D. Online Nursing Learning Framework
Correct Answer: A
Rationale: The correct answer is A: Articulation. This nursing model is referred to as the "class without walls" because it focuses on seamless academic progression and collaboration between educational institutions. Articulation promotes a smooth transition of nursing students from one level of education to another, eliminating barriers and creating a cohesive learning experience. The other choices (B, C, D) do not specifically emphasize the concept of breaking down walls or barriers in education like the Articulation model does.
Which statement related to delegation is correct?
- A. The practice of unlicensed assistive personnel (UAP) is defined in the nurse practice act.
- B. Nursing practice can be delegated only when the LPN/LVN and UAP have received adequate training.
- C. Supervision is not required when routine tasks are delegated to a competent individual.
- D. The RN must be knowledgeable about the laws and regulations that govern nursing practice, as well as those that have no clearly defined parameters, such as for UAP.
Correct Answer: D
Rationale: The correct answer is D because the RN must have knowledge of laws and regulations governing nursing practice, including those that have unclear boundaries for UAP. This is crucial to ensure safe and effective delegation. Option A is incorrect because the nurse practice act typically does not define UAP roles. Option B is incorrect as delegation also requires assessing competency, not just training. Option C is incorrect as supervision is necessary regardless of the task's routine nature. The correct answer emphasizes the importance of legal knowledge for proper delegation.
An interdisciplinary team is evaluating the hospital's care of patients admitted with a myocardial infarction (heart attack) compared to national standards. The team analyzes the hospital's clinical indicator, which would be: (select all that apply)
- A. aspirin order within 24 hours of discharge.
- B. patient teaching related to stopping smoking completed prior to discharge.
- C. beta blocker administered upon arrival.
- D. support of employer to modify stress in workplace.
Correct Answer: A
Rationale: The correct answer is A: aspirin order within 24 hours of discharge. This is a key clinical indicator for evaluating care of heart attack patients as aspirin is a standard treatment to prevent further cardiac events. It is crucial for patient safety and adherence to national guidelines.
Choice B is incorrect as patient teaching on smoking cessation, although important, is not a direct clinical indicator for evaluating care of heart attack patients.
Choice C is incorrect as beta blocker administration upon arrival is important for heart attack patients, but it is not specific to evaluating the hospital's care compared to national standards.
Choice D is incorrect as employer support for stress modification is not a clinical indicator relevant to evaluating care of heart attack patients.
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