Contemporary Issues in Nursing

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A client and her husband used in vitro fertilization to become pregnant. The unused sperm was frozen so the couple could have more children later. The husband is killed while in combat, and the client journals her choices and the possible ramifications. She comes to the fertility clinic after looking at the situation from many perspectives and after considering many alternatives. She asks that the sperm be destroyed because her husband's faith prohibited remarrying, and allowing another person to use the sperm would conflict with her late husband's beliefs. The nurse realizes that:

  • A. the client is in the second step of ethical decision making and that the client's value system is influencing her choices of alternative actions.
  • B. a logical line of reasoning has led to validation of the decision to destroy the husband's sperm.
  • C. the client has not been able to navigate the complicated issues inherent in this situation.
  • D. a rational decision was reached that was based on reflection and on the value systems of the wife and the husband.
Correct Answer: D

Rationale: The correct answer is D because the client's decision to destroy the husband's sperm was based on reflection and the value systems of both the wife and the husband. Firstly, the client considered her late husband's faith and beliefs, showing reflection on his values. Secondly, she analyzed the situation from various perspectives and considered alternatives, indicating a rational decision-making process. This decision was reached after careful consideration of ethical and moral implications, demonstrating a logical and reasoned approach. In contrast, choices A and C imply shortcomings in the client's decision-making process, while choice B focuses solely on validation without considering the underlying reasoning. Therefore, choice D is the most appropriate as it aligns with the client's thoughtful and value-based decision-making process.

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A nurse who wishes to practice in another state: (select all that apply)

  • A. must retake the NCLEX-RN for that state.
  • B. should determine whether the state is a compact state.
  • C. may obtain licensure by endorsement.
  • D. must revoke licensure in the current state because nurses cannot be licensed in more than one state concurrently.
Correct Answer: B

Rationale: Step-by-step rationale:
1. Determining if the state is a compact state is important because nurses from compact states can practice in other compact states without obtaining additional licenses.
2. If the state is not a compact state, the nurse can obtain licensure by endorsement, which means transferring their license to the new state without retaking the NCLEX-RN.
3. Revoking licensure in the current state is not necessary, as nurses can hold licenses in multiple states through either compact agreements or endorsement.
Therefore, the correct answer is B. Choice A is incorrect because the nurse does not have to retake the NCLEX-RN. Choice C is incorrect because obtaining licensure by endorsement is an option. Choice D is incorrect as nurses can hold licenses in multiple states.

Consumers are concerned with security issues related to their confidential health information being placed in an electronic health record (EHR). However, when the security of the EHR is compared with that of paper-and-pencil records, the EHR is:

  • A. more secure.
  • B. less secure.
  • C. equivalent.
  • D. not comparable with the paper-and-pencil record.
Correct Answer: A

Rationale: The correct answer is A: more secure. Electronic Health Records (EHR) typically have built-in security features such as encryption, access controls, and audit trails, making it more secure than paper-and-pencil records. EHRs offer better protection against unauthorized access, tampering, and loss compared to traditional paper records. This is due to the ability to restrict access to specific users, track changes made to the records, and implement authentication measures. Therefore, the security of EHRs surpasses that of paper-and-pencil records. Choices B, C, and D are incorrect because they do not acknowledge the enhanced security measures and advantages that EHRs provide over traditional paper records.

A nurse is very interested in learning more about health care economics and how she can use that knowledge to become a better patient advocate. She comments, "Nurses should not only deliver care one day at a time in one facility but should coordinate patient care as they move from acute care to rehabilitation to home care." This nurse would be a candidate for which nursing role?

  • A. Disease management program (DMP) for chronic illnesses
  • B. A hospital-based utilization management nurse who reviews medical records to determine the most appropriate DRG for patients
  • C. Case management
  • D. Reviewer for Managed Care Organization
Correct Answer: C

Rationale: Rationale:
1. The nurse's interest in coordinating patient care across different settings aligns with the role of a case manager.
2. Case managers focus on ensuring continuity of care and coordinating services for patients transitioning between different healthcare settings.
3. This role involves advocating for patients' needs and optimizing their health outcomes through seamless care transitions.

Summary:
A: DMP focuses on managing chronic illnesses, not coordinating care across settings.
B: Utilization management nurses focus on determining appropriate reimbursement levels, not on care coordination.
D: Reviewers for Managed Care Organizations focus on assessing medical necessity and cost-effectiveness, not on care coordination.

An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation?

  • A. Autocratic
  • B. Democratic
  • C. Laissez-faire
  • D. Referent
Correct Answer: B

Rationale: The most effective nursing leadership style in a crisis like this is democratic. In this situation, collaboration and input from all team members are essential for quick decision-making and effective communication. Democratic leadership promotes teamwork, empowers staff, and fosters open communication, leading to better coordination and outcomes. Autocratic leadership may hinder staff engagement and morale. Laissez-faire lacks direction and may result in chaos during a crisis. Referent leadership focuses on personal relationships rather than team dynamics, not the most effective approach in this urgent situation.

A nurse is newly employed by a state-owned hospital that provides health care insurance requiring a deductible paid by the employee with the majority of the premium cost covered by the employer. The insurance provided to the nurse is:

  • A. private health insurance.
  • B. a federal insurances program known as PPACA.
  • C. state-subsidized Medicaid insurance.
  • D. single-payer system coverage.
Correct Answer: A

Rationale: The correct answer is A: private health insurance. In this scenario, the nurse's insurance is provided by the state-owned hospital, meaning it is not a federal program like PPACA (B) or state-subsidized Medicaid (C). Additionally, it is not a single-payer system (D) since the employer is covering the majority of the premium cost, indicating a private insurance plan. Private health insurance typically involves a deductible paid by the employee, as mentioned in the question. Therefore, the nurse's insurance in this case aligns with the characteristics of private health insurance, making choice A the correct answer.

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