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A group of nurses is presenting the importance of high-quality care during a system- wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm that:
- A. being insured has little effect on a person's longevity and the quality of care received.
- B. lobbyists for the drug companies are able to gain permission for the use of new drugs within 1 year of their discovery.
- C. although a greater number of lawsuits stem from medication errors, more people actually die from human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS).
- D. medication-related errors place a tremendous financial burden on the U.S. health care system.
Correct Answer: D
Rationale: The correct answer is D: medication-related errors place a tremendous financial burden on the U.S. health care system. This answer is correct because medication errors contribute significantly to healthcare costs due to increased hospitalizations, prolonged treatments, and legal expenses. The Quality Chasm report highlights the economic impact of medication errors on the healthcare system, emphasizing the need for improved medication safety practices.
Option A is incorrect because being insured does have a positive impact on a person's access to healthcare services and quality of care. Option B is incorrect as it does not relate to the Quality Chasm findings. Option C is incorrect as it focuses on the comparison of lawsuits and mortality rates related to medication errors and HIV/AIDS, which is not the primary focus of the Quality Chasm report.
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A nurse plans to move to an area that is rich in immigrants from several countries and is concerned about respecting others' cultural beliefs. The nurse's first step to ensure cultural competence and sensitivity is to:
- A. enroll in a nursing theories course to increase knowledge about transcultural practices.
- B. become immersed in nursing literature about culturally diverse clients.
- C. participate in continuing education that focuses on health assessment variations among cultural groups.
- D. conduct a cultural self-assessment.
Correct Answer: D
Rationale: The correct answer is D: conduct a cultural self-assessment. This is the first step to ensure cultural competence because it allows the nurse to reflect on their own beliefs, biases, and cultural background, which can impact interactions with culturally diverse clients. By understanding one's own cultural identity, the nurse can better appreciate and respect the beliefs of others.
Choice A is incorrect because enrolling in a nursing theories course may provide knowledge but does not address the nurse's own biases. Choice B is also incorrect as immersion in nursing literature may increase knowledge but does not promote self-awareness. Choice C is incorrect as focusing on health assessment variations does not necessarily address cultural sensitivity in interactions. Conducting a cultural self-assessment is essential for building a foundation of cultural competence and respect.
When assessing an ethical issue, the nurse must first:
- A. ask, "What is the issue?"
- B. identify all possible alternatives.
- C. select the best option from a list of alternatives.
- D. justify the choice of action or inaction.
Correct Answer: A
Rationale: The correct answer is A because before addressing any ethical issue, it is vital to first identify and define the issue clearly. This helps in understanding the context and scope of the problem. Without knowing the specific ethical issue at hand, it is impossible to proceed with identifying alternatives, selecting the best option, or justifying the choice of action. Therefore, asking "What is the issue?" is the initial step in the ethical decision-making process.
Summary:
- Option B is incorrect because identifying alternatives comes after defining the issue.
- Option C is incorrect as selecting the best option should be based on a clear understanding of the issue.
- Option D is incorrect as justifying actions or inactions should come after determining the ethical problem.
A patient with complicated diabetes is scheduled for a below the knee amputation at 7 AM. The surgical team adheres to the 2012 National Patient Safety Goals by implementing which protocols? (select all that apply)
- A. The surgical team asks the patient to verify his or her name, type of surgery, and limb to be removed.
- B. Ask each member of the surgical team to provide a copy of licensure and, if applicable, certification to patient and family.
- C. The surgical team uses the chart number and name/hospital number to ensure they have the correct patient.
- D. Mark the procedure site with "X" and again ask the patient to verify correct site.
Correct Answer: A
Rationale: The correct answer is A because it aligns with the 2012 National Patient Safety Goals, specifically the goal of improving the accuracy of patient identification. By asking the patient to confirm their name, type of surgery, and limb to be removed, the surgical team is ensuring that they have the correct patient and are performing the correct procedure. This protocol helps prevent errors and ensures patient safety.
Option B is incorrect because asking for licensure and certification does not directly relate to patient safety or accurate patient identification.
Option C is incorrect because relying solely on chart numbers or hospital numbers may not be sufficient to prevent errors in patient identification.
Option D is incorrect because while marking the procedure site is important, relying solely on the patient to verify the correct site may not be as effective as having the healthcare team confirm this information with the patient.
When participating in a nurse licensure compact, the nurse:
- A. is held responsible for complying with the nursing practice laws in the state where practicing at the time care is rendered.
- B. must purchase a license in each state but does not retake the licensure examination.
- C. determines residency based on the state where educated as registered nurse.
- D. may practice using one license in any state or territory in the United States that recognizes the NCLEX as the source of licensure.
Correct Answer: D
Rationale: The correct answer is D because the Nurse Licensure Compact (NLC) allows nurses to practice using one license in any state that is part of the compact and recognizes the NCLEX as the source of licensure. This promotes mobility and access to care across state lines. Choice A is incorrect because the nurse is not held responsible for complying with the nursing practice laws of each state individually. Choice B is incorrect as purchasing a license in each state defeats the purpose of the compact. Choice C is incorrect as residency is not determined by where the nurse was educated but by the state where they hold a license.
A hospital converts to a system of care delivery in which RNs, LPNs, and unlicensed assistive personnel (UAP) are responsible for implementing a specific task, such as medication administration or personal hygiene, for the entire nursing unit. This type of delivery system is:
- A. total patient care.
- B. functional nursing.
- C. team nursing.
- D. primary nursing.
Correct Answer: B
Rationale: The correct answer is B: functional nursing. In functional nursing, tasks are divided among different levels of nursing staff based on their skills and qualifications. This system is task-oriented, with each staff member responsible for a specific function, such as medication administration or personal hygiene, for the entire unit. This allows for efficient and specialized care delivery.
A: Total patient care involves one nurse providing all aspects of care to a group of patients.
C: Team nursing involves a team of healthcare professionals working collaboratively to provide care to a group of patients.
D: Primary nursing assigns one nurse to oversee the care of a group of patients from admission to discharge.