A nurse is caring for a patient who has a prescription for a referral for case management services. Which action should the nurse identify is the responsibility of case management services?

Write a prescription for the patient's medications.

Perform nursing skills for the patient such as dressing changes.

Arrange for the patient to receive home health services.

Provide education to the patient about adverse effects of their medications.

Answer and Explanation

The Correct Answer is C

Case management is a coordinated care delivery system that focuses on resource utilization, interdisciplinary collaboration, continuity of care, and care transitions, ensuring patients receive appropriate services across healthcare settings while optimizing outcomes and reducing fragmentation of care.

Rationale:

A. Writing a prescription for medications is outside the scope of case management. This is a prescriber responsibility (physician, nurse practitioner, or authorized provider) and involves pharmacologic decision-making, not coordination of care services.

B. Performing nursing skills such as dressing changes is a direct care nursing function. Case managers do not provide hands-on clinical procedures; instead, they coordinate services and ensure appropriate providers are assigned for direct care interventions.

C. Arranging for home health services is a primary responsibility of case management. It involves coordinating post-discharge care, ensuring continuity, and linking patients with community-based resources to support recovery and reduce hospital readmissions.

D. Providing medication education is typically a bedside nursing responsibility. While case managers may reinforce education, their primary role is system coordination rather than direct patient teaching or medication-specific counseling.

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Correct Answer is A

Explanation

Conflict within nursing management arises from the divergence of goals, values, or roles between individuals or groups. These psychological or social tensions can lead to moral distress or burnout if not resolved through effective communication and negotiation strategies during high-stress clinical staffing shortages.

Rationale:

A. Intrapersonal conflict occurs internally when an individual faces opposing desires or obligations. The nurse is torn between the professional duty to the healthcare facility and a personal commitment to family. This internal struggle represents a clash of competing values within a single person.

B. Intergroup conflict involves disputes between different departments or teams, such as the emergency department and the intensive care unit. It focuses on organizational friction rather than individual dilemmas. This scenario does not describe a struggle between two distinct functional groups.

C. Interpersonal conflict is a disagreement between two or more specific individuals, often involving differing perspectives or personalities. While the manager made the request, the core issue is the nurse’s internal struggle with the decision. It is not characterized as a confrontational exchange between the parties.

D. Group conflict occurs when members of a single team disagree on goals, tasks, or leadership within that specific unit. This scenario describes an individual’s struggle with external demands rather than a collective disagreement among staff members. It does not reflect a collaborative breakdown within the group.

A. Closed right femur fracture, pedal pulses strong, capillary refill less than 2 second B. Shortness of breath, symmetrical chest wall movement, 02 saturations 85% C. Severe bleeding of facial and head lacerations, oriented to person, place, and time D. Chest pain, blood pressure 90 systolic, heart rate 130, respirations 36 breaths/min

Correct Answer is A

Explanation

Disaster triage utilizes the START framework to rapidly categorize victims based on hemodynamic stability and respiratory status. Clinical priority is determined by physiological urgency, where immediate interventions target life-threatening asphyxiation or hemorrhage, while stable injuries are relegated to the delayed category to optimize resource allocation.

Rationale:

A. A closed femur fracture with strong pulses and normal capillary refill indicates a hemodynamically stable patient. This victim is categorized as delayed because their injuries do not pose an immediate threat to life or limb. They can safely wait for treatment until more critical patients are stabilized.

B. An oxygen saturation of 85% signifies hypoxemia and requires immediate respiratory support to prevent respiratory failure. This patient is a high priority because impaired gas exchange can lead to rapid physiological collapse during a mass casualty event. They require urgent supplemental oxygen and monitoring.

C. Head and facial lacerations often result in profuse bleeding due to high vascularity in those anatomical regions. Rapid hemostasis is required to prevent hypovolemic shock, even if the patient is currently oriented to person, place, and time. This patient takes precedence over those with stable fractures.

D. Tachycardia and a low systolic blood pressure suggest the onset of decompensated shock following the trauma. Tachypnea at 36 breaths/min indicates severe cardiopulmonary distress, necessitating immediate medical intervention to stabilize the patient's vital signs. This victim is classified as immediate due to unstable hemodynamics.

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