A nurse at a school notices that several students have "blisters" on their bodies. Further investigation reveals that a terrorist incident has occurred, causing smallpox. If the chemical, biologic, radiologic, nuclear, and explosive (CBRNE) agent categories are used, this incident would be classified as:
- A. chemical.
- B. biologic.
- C. radiologic.
- D. nuclear.
Correct Answer: B
Rationale: The correct answer is B: biologic. Smallpox is a viral disease caused by the variola virus, making it a biological agent. The virus spreads from person to person through respiratory droplets or contact with infected bodily fluids. The term CBRNE encompasses various types of agents used in terrorism incidents. In this case, the incident involving smallpox falls under the biologic category due to its viral nature, as opposed to chemical (A), radiologic (C), or nuclear (D) agents. Chemical agents involve toxic substances, radiologic agents involve radiation, and nuclear agents involve nuclear materials. In summary, the smallpox incident is categorized as biologic due to the nature of the variola virus.
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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.
A new graduate nurse is applying for the exciting first position and states, "I am only applying to Magnet hospitals because those work environments:
- A. attract physicians who are the best health care providers to improve quality of care."
- B. require all registered nurses to be certified in the area of practice."
- C. not only attract but also retain professional nurses."
- D. discourage nurses from advancing their current level of education and I don't want to return to school for many years."
Correct Answer: C
Rationale: The correct answer is C because Magnet hospitals are recognized for their ability to not only attract but also retain professional nurses. These hospitals create a positive work environment that values and supports nursing staff, leading to higher job satisfaction and lower turnover rates. Choice A is incorrect because while Magnet hospitals may attract top healthcare providers, it's not solely focused on physicians. Choice B is incorrect as certification is not a mandatory requirement for all RNs in Magnet hospitals. Choice D is incorrect as Magnet hospitals actually encourage nurses to advance their education and professional development.
A state is devastated by a tornado killing many people, destroying communication systems, utility services, homes, and medical facilities. The state requests immediate assistance from the U.S. Congress and from surrounding states. The affected state should first contact the:
- A. Emergency Management Assistance Compact (EMAC).
- B. Institute of Medicine (IOM).
- C. Red Cross.
- D. Strategic National Stockpile.
Correct Answer: A
Rationale: The correct answer is A: Emergency Management Assistance Compact (EMAC).
1. EMAC is a mutual aid agreement among states for disaster response.
2. It allows affected states to request and receive assistance from other states.
3. It facilitates coordination and deployment of resources quickly in emergencies.
4. IOM focuses on health research, Red Cross on humanitarian aid, and Strategic National Stockpile on medical supplies, but they do not provide the immediate multi-sectoral assistance needed in this scenario.
The mentor states, "Prevention was the focus of nursing when I graduated. We stressed preventive health measures such as smoking cessation education to reduce preventable diseases and prevention to reduce the spread of infectious disease such as AIDS." The mentor asks, "What do you think the challenges will be for nurses graduating now? The correct response would be: (select all that apply)
- A. coordinating care for a more diverse aging population who have complex health values.
- B. managing care provided by nurses who are technologically advanced and skilled at interprofessional collaboration.
- C. providing care to well-informed consumers who are younger with narrow health values.
- D. redesigning nursing care delivery models to streamline care based on fewer generational differences.
Correct Answer: A
Rationale: Step 1: The correct answer is A because nurses now face challenges in coordinating care for a more diverse aging population. This is due to the increasing complexity of health issues and values among this demographic.
Step 2: As the aging population grows, nurses must be equipped to address the unique needs and preferences of diverse individuals, which requires a deep understanding of cultural, social, and health-related factors.
Step 3: Nurses need to adapt their care delivery strategies to provide patient-centered care that considers the individual's values, beliefs, and preferences. This includes coordinating care across different healthcare settings and disciplines to ensure holistic and effective care.
Summary: Choices B, C, and D are incorrect because they do not address the specific challenges faced by nurses graduating now, which primarily revolve around managing the complexities of caring for a diverse aging population with varying health values.
A student nurse is preparing a presentation that requires identification of outcomes for the care of heart failure patients. Which is a correctly written outcome?
- A. Develop a teaching program to address physical activities that result in improved cardiac function.
- B. Discuss the clinical manifestations associated with Level 4 heart failure.
- C. List the most common pharmaceutical approaches to reduce preload in heart failure patients.
- D. Recognize the economic impact that recidivism has on the patient and health care facility.
Correct Answer: A
Rationale: The correct answer is A because it specifies a measurable and achievable goal related to improving cardiac function through physical activities. It follows the SMART criteria (Specific, Measurable, Achievable, Relevant, Time-bound). Option B does not provide a specific outcome, while Option C focuses on pharmaceutical approaches rather than outcomes. Option D is unrelated to the goal of improving outcomes for heart failure patients. Thus, option A is the most appropriate choice for a well-defined and relevant outcome for the care of heart failure patients.
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