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A client is admitted with chest pain. A series of diagnostic tests are ordered, and the client undergoes coronary artery bypass grafting. The cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (ICU) stay by 3 days because of respiratory problems. The case manager realizes that under the terms of the diagnosis-related group (DRG) payment system for this diagnosis:
- A. the cost of caring for this client was $5000 greater than the DRG reimbursement fee, and the hospital will be allowed to collect the additional fees from the insurance company.
- B. although the cost of care for this client was greater than the DRG reimbursement amount, the hospital will be reimbursed only at the set fee.
- C. the client will be sued to pay back the insurance company for the extra fees incurred because smoking is a modifiable health risk for heart disease.
- D. the physician who admitted the client will receive a reduced payment to cover the loss incurred by the hospital.
Correct Answer: B
Rationale: The correct answer is B. The DRG payment system is a fixed reimbursement amount for a specific diagnosis or procedure. In this case, the cost of care exceeded the DRG reimbursement amount due to the extended ICU stay caused by the client's smoking history. The hospital will only be reimbursed at the set fee specified by the DRG, regardless of the actual cost incurred.
Choice A is incorrect because the hospital cannot collect additional fees from the insurance company beyond the DRG reimbursement amount. Choice C is incorrect as the client is not typically held responsible for the additional costs incurred. Choice D is incorrect because physician payment is not directly impacted by the hospital's financial losses. The DRG system focuses on fixed reimbursements based on diagnoses, not individual physician payments.
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A bronze statue of a nurse in battle fatigues who is obviously exhausted but demonstrates caring by holding a soldier's head is an artistic representation of nurses who served in which war?
- A. World War I
- B. World War II
- C. Spanish-American War
- D. Vietnam War
Correct Answer: B
Rationale: The correct answer is B: World War II. This statue represents the iconic image of a nurse caring for a soldier during WWII. Nurses played a crucial role in providing medical care and support during the war, often under extreme conditions. The exhausted yet caring portrayal of the nurse holding the soldier's head captures the compassion and dedication of nurses during WWII.
Explanation for other choices:
A: World War I - While nurses also served valiantly in WWI, the imagery of this statue is more closely associated with WWII.
C: Spanish-American War - Nurses did serve in this war, but the statue's depiction aligns more with the context of WWII.
D: Vietnam War - The statue's portrayal does not align with the historical context or imagery commonly associated with nurses in the Vietnam War.
A student is planning to enroll in prerequisite courses after graduating from high school and is researching options for nursing programs. During a career fair the student compares different types of nursing education programs and discovers that:
- A. diploma programs focus on family and community, with an emphasis on health promotion.
- B. most practicing RNs graduated from diploma programs because this was the first type of RN program.
- C. baccalaureate programs focus on technical and hands-on nursing skills in diverse community settings.
- D. master's programs such as that for the clinical nurse leader provide entry into practice with a focus on interdisciplinary and bedside nursing care for complex client populations.
Correct Answer: D
Rationale: The correct answer is D because master's programs, like the one for clinical nurse leaders, indeed provide entry into practice with a focus on interdisciplinary and bedside nursing care for complex client populations. This choice stands out as it specifically addresses the advanced level of education and specialization required for handling complex cases.
Choice A is incorrect because diploma programs typically focus on basic nursing skills rather than specialization in complex client populations.
Choice B is incorrect as most practicing RNs nowadays graduate from associate's or bachelor's degree programs, not diploma programs.
Choice C is incorrect because baccalaureate programs emphasize a broader education including leadership, research, and critical thinking skills rather than just technical and hands-on nursing skills.
When deciding whether and when a task should be completed, a nurse must:
- A. complete all tasks as they are thought of to prevent having to take time to consider which is most important.
- B. procrastinate and hope that someone will volunteer to do it.
- C. ask, "What will happen if I don't complete the task now?"
- D. view large projects holistically and not as many small pieces.
Correct Answer: C
Rationale: The correct answer is C: ask, "What will happen if I don't complete the task now?" This is the best approach as it helps prioritize tasks based on their urgency and importance. By considering the consequences of not completing a task immediately, the nurse can focus on critical tasks first to ensure patient safety and efficient workflow.
Choice A is incorrect because completing all tasks as they are thought of without prioritizing can lead to neglecting important tasks and compromising patient care. Choice B is incorrect as procrastination is not a professional or effective way to manage tasks in a healthcare setting. Choice D is incorrect as viewing large projects holistically is important, but it doesn't address the immediate need to prioritize individual tasks.
The nurse manager meets with upper management to share strategic goals agreed upon by her staff for their individual nursing unit as the first step to begin budget negotiations. One strategic goal is that staff will have access to technology that will allow them to incorporate point-of-care devices for all RNs. The second goal is to improve RNs' ability to recognize critical indicators that a patient's health status is deteriorating through advanced health assessment skills. During the meeting the manager discusses the strategy options and selecting the one that works for the unit. Which type of budget development is used?
- A. Iterative
- B. Top-down
- C. Participatory
- D. Zero-based
Correct Answer: C
Rationale: The correct answer is C: Participatory. In participatory budget development, input is gathered from various levels within the organization, such as staff and managers. In this scenario, the nurse manager met with her staff to establish strategic goals before budget negotiations, indicating a participatory approach. This allows for staff buy-in and ownership of the goals.
A: Iterative budget development involves refining a budget through multiple rounds of review, which is not explicitly mentioned in the scenario.
B: Top-down budget development is characterized by decisions made by upper management without input from lower levels, contradicting the scenario where staff provided input.
D: Zero-based budgeting starts from scratch without considering previous budgets, which is not evident in the scenario where goals were established based on staff input.
In summary, the participatory budget development is the appropriate choice in this scenario as it aligns with the collaborative approach taken by the nurse manager and her staff in setting strategic goals before budget negotiations.
A new graduate secures the first interview and wants to work where cultural diversity is appreciated. The applicant feels that accepting this interview was the right choice when the recruiter states, "We do not discriminate based on sex, race, or age and practice inclusiveness of diversity." Which question would reflect this statement?
- A. "Nurses must work a master schedule where one month is Monday through Friday and the next month is the weekend shift. What is your religious belief about working on Sunday?"
- B. "We offer many benefits for employees such as educational benefits and health insurance."
- C. "Our mission is to provide patient-centered care that reflects the belief of the patient and family with an aim to win them over to Western medicine and less superstition, don't you agree?"
- D. "Do you have any issues with working with patients who are from a disadvantaged background because we have many people who refuse to work then want free care?"
Correct Answer: B
Rationale: The correct answer is B because it focuses on the benefits offered to employees, which aligns with the recruiter's statement about inclusiveness and non-discrimination. Asking about educational benefits and health insurance shows that the organization values its employees' well-being and development regardless of their background.
Choice A is incorrect because it is discriminatory to ask about religious beliefs related to work schedules. Choice C is incorrect because it promotes a biased perspective on patient care and cultural beliefs. Choice D is incorrect as it implies a negative stereotype about patients from disadvantaged backgrounds, which goes against the principles of inclusivity and non-discrimination stated by the recruiter.