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A group of nurses are assembling outside a hospital protesting the use of foreign nurses after several nurses were terminated due to what the hospital called recurring "decreased census." The nurses carry signs with messages asking potential patients to seek care elsewhere. The local newspaper picked up the story, and the hospital is receiving negative press. The nurses are participating in:
- A. picketing.
- B. collective bargaining.
- C. a strike.
- D. arbitration.
Correct Answer: A
Rationale: The correct answer is A: picketing. Picketing involves protesting outside a workplace to draw attention to an issue, such as the use of foreign nurses in this case. The nurses are not actively refusing to work (strike), negotiating work conditions (collective bargaining), or submitting their dispute to a third party for resolution (arbitration). Picketing is the most appropriate term for their actions in this scenario.
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A patient presents with chest pain that increases when lying flat and low-grade fever. Assessment reveals muffled heart sounds, tachycardia, and 3+ edema in the lower extremities. The nurse asks the patient to learn forward, which eases respiratory efforts. The nurse then places the stethoscope at which area on the chest to facilitate auscultation? The above question represents which type of alternate-format question written at which level of Bloom's taxonomy?
- A. Multiple-response item, comprehension level
- B. Hot-spot item, analysis level
- C. Chart/exhibit item, application level
- D. Drag-and-drop item, knowledge level
Correct Answer: B
Rationale: The correct answer is B: Hot-spot item, analysis level. In this scenario, the patient's symptoms suggest pericardial effusion or cardiac tamponade. To facilitate auscultation, the nurse should place the stethoscope at the point of maximal intensity of the heart sounds, which is typically at the apex of the heart or the lower left sternal border. This requires the nurse to analyze the patient's symptoms and apply knowledge of cardiac anatomy to determine the optimal auscultation site.
A: Multiple-response item, comprehension level - This choice involves selecting multiple correct answers from a list of options based on understanding the presented information. It doesn't require the critical thinking and analysis needed in this scenario.
C: Chart/exhibit item, application level - This choice involves interpreting information presented in a chart or exhibit to apply it to a specific situation. While it involves application, it doesn't require the same level of analysis as determining the best auscultation site.
D: Drag-and
A patient's spouse was just diagnosed with lung cancer although there was no history of tobacco use. The spouse states, "I am so mad. How can you get cancer without smoking?" Which statement by the nurse represents empathy?
- A. "Research is identifying many risk factors for cancer besides smoking."
- B. "I understand how you could feel angry about the diagnosis."
- C. "He is still a good husband."
- D. "Why do you think he got cancer?"
Correct Answer: B
Rationale: The correct answer is B because it demonstrates empathy by acknowledging and validating the spouse's feelings of anger. By stating, "I understand how you could feel angry about the diagnosis," the nurse shows compassion and understanding towards the spouse's emotional response. This response helps to build trust and rapport with the patient's spouse during a difficult time.
Choice A is incorrect as it focuses more on providing information rather than acknowledging the spouse's emotions. Choice C is incorrect as it does not address the spouse's feelings of anger and is not relevant to the situation. Choice D is incorrect as it comes across as confrontational and may make the spouse feel defensive.
The staff on a nursing unit notes that patient satisfaction varies from month to month. They plot the degree of patient satisfaction each month for 1 year to determine when the periods of greatest dissatisfaction are occurring. The staff uses which type of graph?
- A. Time plot
- B. Pareto chart
- C. Flowchart
- D. Cause-and-effect diagram
Correct Answer: A
Rationale: The correct answer is A: Time plot. A time plot is the most appropriate graph for displaying data over time to identify trends and patterns. In this scenario, plotting patient satisfaction levels monthly over a year allows the staff to analyze fluctuations and identify periods of greatest dissatisfaction accurately.
Summary of other choices:
B: Pareto chart - Pareto charts are used to display the frequency of occurrences in a dataset in descending order. It is not suitable for analyzing trends over time.
C: Flowchart - Flowcharts are used to represent processes and workflows, not suitable for displaying time-series data.
D: Cause-and-effect diagram - Cause-and-effect diagrams are used to identify and analyze potential causes of a problem, not suitable for displaying time-series data.
Nurses in a nonprofit hospital have expressed an interest in forming a union to secure fair wages and ensure client safety. To form a core support group of nurses, the union organizer can conduct meetings to gather initial information:
- A. away from the worksite with a group of managers to learn both sides of the situation.
- B. at the worksite with staff nurses who are respected leaders.
- C. in homes or local businesses with staff nurses.
- D. after photographing management meeting to discuss their strategies to decrease interest in unionization.
Correct Answer: B
Rationale: The correct answer is B because conducting meetings at the worksite with respected staff nurses allows for direct engagement with potential union supporters. This approach fosters a sense of unity and trust among the nurses, making it easier to form a core support group. Additionally, meeting at the worksite enables easy access for all nurses and ensures a safe and neutral environment for discussions.
Choices A, C, and D are incorrect because:
A: Meeting away from the worksite with managers may create a conflict of interest and could lead to a biased understanding of the situation.
C: Meeting in homes or local businesses may not provide a professional setting for discussions and may not be convenient for all nurses to attend.
D: Photographing management meetings and discussing their strategies is unethical and could potentially harm the relationship between nurses and management.
When the nurse manager conducts a qualitative analysis of budget variances, he or she is:
- A. determining the percentage increase of supply usage from the last quarter to the current quarter.
- B. identifying the overall increase in the dollar amount of salaries paid for overtime.
- C. comparing productivity metrics across all nursing units in the facility.
- D. reconciling with current conditions the underlying assumptions on which the budget was based.
Correct Answer: D
Rationale: The correct answer is D because when a nurse manager conducts a qualitative analysis of budget variances, they need to reconcile the underlying assumptions on which the budget was based with current conditions. This involves reviewing the initial budget assumptions to see if they still hold true and adjusting them accordingly. This step ensures that the budget remains relevant and accurate.
A is incorrect because determining the percentage increase of supply usage does not involve a qualitative analysis of budget variances. B is incorrect because identifying the overall increase in the dollar amount of salaries paid for overtime is a quantitative analysis, not qualitative. C is incorrect because comparing productivity metrics across nursing units is a different type of analysis and not specifically related to budget variances.