Nokea
A concern that nurses were being asked to perform tasks that went beyond the state's nurse practice act was brought to the union's attention. Nurses were informed that either mediation or binding arbitration will be used to resolve the issue. A novice nurse asks about the difference between these techniques and is informed that:
- A. mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor.
- B. binding arbitration is a formal discussion between labor and management in which the arbitrator's recommendations are compulsory.
- C. mediation uses a trained person to negotiate a legally binding plan.
- D. binding arbitration requires both labor and management to participate in discussions on the least destructive approach to allow self-governance by employees.
Correct Answer: B
Rationale: The correct answer is B because binding arbitration involves a formal discussion where the arbitrator's recommendations are compulsory, meaning both parties must abide by the decision. This ensures a resolution to the issue at hand.
A is incorrect because mediation is not necessarily sanctioned by the NLRB for formal discussions.
C is incorrect because mediation does not typically result in a legally binding plan; it is a negotiation process to reach a mutually acceptable agreement.
D is incorrect because binding arbitration does not specifically focus on the least destructive approach or self-governance by employees; it is about reaching a binding decision by a neutral third party arbitrator.
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In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees' health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin's planned change?
- A. Unfreeze
- B. Move
- C. Refreeze
- D. Acceptance
Correct Answer: A
Rationale: The correct answer is A: Unfreeze. In this scenario, the handout is aimed at creating dissatisfaction with the current state of health insurance among employees, which aligns with the unfreezing stage of Lewin's planned change model. Unfreezing involves creating awareness of the need for change by highlighting deficiencies in the current state. The handout is triggering employees to reevaluate their current health insurance and consider alternative options. Choices B, C, and D are incorrect because they do not capture the initial stage of creating dissatisfaction and readiness for change, as seen in the unfreezing phase.
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 nurse caring for a patient with anemia and heart failure prepares to hang a unit of packed red blood cells and realizes her break is in 5 minutes. She decides it is not necessary to have another nurse check the blood against the patient's information since the patient's blood type is O+ which she incorrectly remembered to be the universal donor. She hangs the blood, noting the patient is "reading and vital signs normal." She leaves the floor for her break and does not report leaving or ask anyone to perform required vital signs. Upon returning she meets a family friend who is visiting and time "just flies." She returns to the patient's room after admitting a new patient. The patient is hypotensive and color is cyanotic and anxious. She reports the findings to the charge nurse, who then contacts the physician. A blood reaction occurrence is noted. The nurse providing care is charged:
- A. with comparative negligence.
- B. with a preventable adverse event.
- C. with criminal negligence.
- D. under the doctrine of res ipsa loquitur.
Correct Answer: C
Rationale: The correct answer is C: with criminal negligence. The nurse displayed a reckless disregard for the patient's safety by not verifying the blood type, leaving for an extended break without ensuring proper monitoring, and failing to report her absence. These actions were highly irresponsible and demonstrated a severe lack of care and attention to the patient's well-being. Criminal negligence involves a conscious disregard for the consequences of one's actions, which in this case resulted in a serious adverse event for the patient. Choices A and B do not fully capture the gravity of the nurse's actions, as they imply a lesser degree of fault. Choice D, under the doctrine of res ipsa loquitur, would be inappropriate in this scenario as the nurse's actions directly contributed to the adverse outcome.
Diagnosis-related groups (DRGs) have attempted to reduce health care costs by decreasing:
- A. hospital admission rates.
- B. length of hospital stay.
- C. outpatient services.
- D. specialty groups.
Correct Answer: B
Rationale: The correct answer is B: length of hospital stay. DRGs aim to reduce healthcare costs by incentivizing hospitals to provide efficient care and discharge patients sooner. Shortening the length of hospital stay helps decrease overall healthcare expenses without compromising the quality of care. Choices A, C, and D are incorrect because DRGs focus on the duration of hospitalization, not necessarily on hospital admission rates, outpatient services, or specialty groups. Shortening hospital stays is a more direct way to control costs within the inpatient setting.
A nurse asks, "What is meant by 'internal' customers?" The correct response is: (select all that apply)
- A. insurance companies
- B. accreditors such as The Joint Commission
- C. X-ray technicians
- D. clinical pharmacist
Correct Answer: C
Rationale: The correct answer is C: X-ray technicians. Internal customers refer to individuals or departments within the same organization who rely on each other's services to fulfill their roles effectively. X-ray technicians work within the healthcare facility and depend on other staff like nurses for patient care coordination. Insurance companies (A) and accreditors (B) are external entities. Clinical pharmacists (D) are also internal, but X-ray technicians have a direct service-dependency relationship with nurses in healthcare settings, making them the most relevant internal customers in this context.