Ethics and Issues in Contemporary Nursing

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A nurse develops a new nursing theory related to stress and viability. The nurse determines the theory accounts for historical events in which soldiers suffering from the stress of inadequate clothing to protect them from the cold and lack of correspondence from home had an increased mortality related to gunshot wounds. The theory will predict gunshot victims' need for proper clothing and letters from significant others as they serve in Iraq. Which criterion for theory acceptance is being validated?

  • A. Inclusiveness
  • B. Consistency
  • C. Accuracy
  • D. Simplicity
Correct Answer: C

Rationale: The correct answer is C: Accuracy. The nurse's theory is being validated based on its ability to accurately predict the need for proper clothing and letters from significant others for soldiers serving in Iraq. This criterion is essential for theory acceptance as it demonstrates the theory's ability to make accurate predictions based on historical events.

Inclusiveness (A) refers to the theory's ability to encompass a wide range of phenomena, which is not explicitly demonstrated in this scenario. Consistency (B) refers to the theory's internal coherence and agreement with existing knowledge, which is not the focus of the nurse's validation process in this case. Simplicity (D) refers to the theory's clarity and parsimony, which is not the primary criterion being validated here.

In summary, accuracy is the most relevant criterion being validated in this scenario as the nurse's theory is being assessed based on its predictive accuracy in relation to the soldiers' needs in Iraq.

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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.

As part of a quality assurance project, a nurse is to round on every patient daily for 1 month to ensure the intravenous tubing is labeled with date hung and nurse's initials. The nurse is hoping to be promoted to a full-time position within the quality department, and her success on this project is very important to her receiving the position. The nurse retains all other assignments, and she is often interrupted to help other staff or answer call lights. The nurse discusses her concerns with the manager, who frees her for 1 hour each day to make rounds. During this 1 hour each day the nurse will organize herself and environment by practicing the:

  • A. art of "no detourism."
  • B. reducing stacked-desk syndrome.
  • C. art of "wastebasketry."
  • D. managing e-mail and memo mania.
Correct Answer: B

Rationale: The correct answer is B: reducing stacked-desk syndrome. This term refers to the practice of organizing tasks and environment to prevent work from piling up. In this scenario, the nurse is given 1 hour each day to focus solely on the quality assurance project, helping her prevent tasks from accumulating and ensuring she can complete her rounds efficiently. This practice enhances productivity and enables the nurse to manage her workload effectively.

Choice A, "art of 'no detourism,'" is irrelevant in this context as it does not address the issue of organizing tasks and environment. Choice C, "art of 'wastebasketry,'" is not applicable as it pertains to the skill of decision-making and prioritization, which is not the primary concern in this scenario. Choice D, "managing e-mail and memo mania," is also not directly related to the nurse's need to organize herself and environment for the quality assurance project.

Current trends in telecommunications and increased mobility of nurses have led to the approval of a mutual recognition model of nursing regulation, in which nurses are allowed to practice in states that are compact states without obtaining a license in each state. On which website would a nurse find a list of current compact states?

  • A. National League for Nursing (NLN)
  • B. National Council of State Boards of Nursing (NCSBN)
  • C. American Association of Colleges of Nursing (AACN)
  • D. Commission on Collegiate Nursing Education (CCNE)
Correct Answer: B

Rationale: The correct answer is B: National Council of State Boards of Nursing (NCSBN). NCSBN manages the Nurse Licensure Compact (NLC), which allows nurses to practice in compact states without obtaining additional licenses. Nurses can find a list of current compact states on the NCSBN website. NLN (A) focuses on nursing education, not regulation. AACN (C) is an organization for academic nursing programs. CCNE (D) accredits nursing education programs, not regulatory information.

A nurse is concerned that the policy of using povidone-iodine (Betadine) to clean foot ulcers may lead to unwarranted allergic reactions and drying of surrounding tissue. A literature review is performed to determine the "best practice" related to care of foot ulcers. This nurse: (select all that apply)

  • A. is applying evidence-based practice to the clinical setting.
  • B. is using critical thinking to change procedures performed in the care of foot ulcers.
  • C. is minimally educated at the master's level and participating in research to provide cost-effective care (soap is less expensive than povidone-iodine).
  • D. lacks clinical competence in health assessment and in application of theory to the clinical setting.
Correct Answer: A

Rationale: The correct answer is A because the nurse is using evidence-based practice by conducting a literature review to determine the best practice for caring for foot ulcers. Evidence-based practice involves integrating the best available evidence with clinical expertise and patient values to make informed decisions about patient care. This nurse is ensuring that the care provided is based on current research and best practices, which can lead to better patient outcomes.

Choices B, C, and D are incorrect because they do not directly relate to the nurse's action of conducting a literature review to determine best practices for foot ulcer care. Choice B mentions critical thinking but does not specifically address evidence-based practice. Choice C focuses on cost-effectiveness and level of education, which are not relevant to the nurse's evidence-based practice. Choice D refers to clinical competence, which is not the main focus of the nurse's action in this scenario.

The first university to offer nursing graduates a baccalaureate degree was:

  • A. Columbia Teachers College.
  • B. Yale University.
  • C. Harvard University.
  • D. the New York Regents Program.
Correct Answer: A

Rationale: The correct answer is A: Columbia Teachers College. This institution was the first to offer nursing graduates a baccalaureate degree, pioneering the advancement of nursing education. Columbia Teachers College had a dedicated nursing program that emphasized academic and clinical training, setting the standard for future nursing education.

Explanation:
A: Columbia Teachers College - Correct. Pioneered baccalaureate degree for nursing graduates.
B: Yale University - Incorrect. Not historically known for offering the first baccalaureate degree in nursing.
C: Harvard University - Incorrect. Focused on medical education, not nursing, at the time.
D: New York Regents Program - Incorrect. Not a university and did not offer baccalaureate degrees in nursing.

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