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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 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.
A current trend is for students to be evaluated to determine whether they demonstrate competence in the actual client care environment or with a standardized patient. This process occurs in addition to or instead of traditional pencil-and-paper evaluations. This type of evaluation is referred to as:
- A. core practice competencies.
- B. continuing competence.
- C. distance learning.
- D. performance-based assessment.
Correct Answer: D
Rationale: The correct answer is D: performance-based assessment. This type of evaluation focuses on assessing students' ability to perform tasks and demonstrate competence in real-world scenarios, such as client care environments or with standardized patients. It is a more practical and hands-on approach compared to traditional pencil-and-paper evaluations. Core practice competencies (A) refer to essential skills and knowledge required for a specific profession. Continuing competence (B) involves ongoing professional development to maintain skills and knowledge. Distance learning (C) is a method of education that does not require physical presence in a traditional classroom setting. Performance-based assessment best aligns with the description provided in the question, making it the correct choice.
The primary focus of the care provider role for the nurse involves:
- A. using the nursing process to provide guidance to the patient in recovery.
- B. encouraging consumer self-responsibility and emphasizing health promotion/maintenance.
- C. focusing on increasing satisfaction among professional nurses.
- D. advancing nursing practice through research.
Correct Answer: B
Rationale: The correct answer is B because the primary focus of the care provider role for a nurse is to encourage consumer self-responsibility and emphasize health promotion/maintenance. This involves empowering patients to take control of their own health, promoting wellness, and preventing illness. The other choices are incorrect because: A) using the nursing process is essential but not the primary focus, C) increasing satisfaction among professional nurses is important but not the primary role of a care provider, and D) advancing nursing practice through research is valuable but not the primary responsibility of a care provider.
The NCLEX examination is created and administered by the:
- A. American Association of Colleges of Nursing (AACN).
- B. American Nurses Association (ANA).
- C. National Council of State Boards of Nursing (NCSBN).
- D. National League for Nursing (NLN).
Correct Answer: C
Rationale: The correct answer is C: National Council of State Boards of Nursing (NCSBN). The NCLEX examination is developed and administered by the NCSBN, which is responsible for regulating nursing practice in the United States. They create the exam to ensure that nurses entering the profession meet minimum competency standards. The AACN (choice A) focuses on advancing nursing education, the ANA (choice B) is a professional organization representing nurses, and the NLN (choice D) is an organization that promotes excellence in nursing education. Therefore, the NCSBN is the only organization directly involved in the creation and administration of the NCLEX exam.
A physician bills the insurance company for a computed tomography (CT) scan, laboratory tests, chest x-ray, and an extended visit and receives revenue for each procedure billed. This type of payment system is a payment system.
- A. prospective
- B. retrospective
- C. diagnosis-related group
- D. capitated
Correct Answer: D
Rationale: The correct answer is D: capitated. In a capitated payment system, the physician receives a fixed amount per patient regardless of the services provided. This incentivizes cost-effective care and promotes preventive measures. In this scenario, the physician is receiving revenue for each procedure billed, which is not characteristic of capitated payment.
A: Prospective payment is when a fixed amount is determined in advance for specific services rendered. This is not the case in the scenario provided.
B: Retrospective payment involves reimbursement after the services are provided, which is not reflected in the scenario given.
C: Diagnosis-related group (DRG) is a payment system used in hospitals based on the diagnosis and procedures performed, not applicable to individual physician billing as presented in the question.