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A nurse is concerned about a trend in the hospital to regularly "float" nurses to different areas of the hospital based on staff shortage regardless of recent experience in caring for the population on the unit. When deciding to accept a staffing assignment in this situation, the nurse considers a "safe harbor." What is meant by "safe harbor"?
- A. In an emergency situation, nurses may move patients to one location designated to be areas safe from natural disasters or acts of terrorism.
- B. Nurses work in teams to care for patients who have no communicable disease and do not pose a safety issue due to infection.
- C. Horizontal violence is not tolerated and nurses report any form of violence to administration.
- D. It is written a notice about recurrent staffing issues that allows nurses to continue to care for patients placed in their care but protects their nurse's license while an investigation is conducted.
Correct Answer: D
Rationale: The correct answer is D because "safe harbor" refers to a legal provision that protects nurses when they feel unsafe accepting a staffing assignment due to lack of recent experience or competency. By invoking safe harbor, nurses can continue caring for patients while an investigation is conducted to ensure patient safety and protect the nurse's license. This process allows nurses to voice concerns without fear of reprisal.
Option A is incorrect as it refers to a disaster response plan, unrelated to safe harbor. Option B is incorrect as it discusses patient care teams and infectious diseases, not safe harbor protections. Option C is incorrect because it addresses reporting violence, which is not directly related to safe harbor provisions for staffing assignments.
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During the relief response phase of a disaster resulting from a "dirty bomb":
- A. treatment for burns and poisoning is provided for victims.
- B. emergency plans are coordinated between agencies.
- C. reconstruction of destroyed facilities and homes begins.
- D. food stores are collected for potential victims.
Correct Answer: A
Rationale: The correct answer is A because during the relief response phase of a "dirty bomb" disaster, victims are likely to suffer from burns and poisoning due to radiation exposure. Providing treatment for burns and poisoning is crucial to saving lives and preventing further health complications.
Choice B is incorrect because emergency plans coordination typically occurs during the preparedness phase, not the relief response phase. Choice C is incorrect as reconstruction usually takes place in the recovery phase, which follows the relief response phase. Choice D is incorrect as collecting food stores is more related to preparedness or immediate response, not specifically during the relief response phase.
A nurse is reading about positive reinforcement with the goal of increasing staff motivation. Which action would demonstrate positive reinforcement?
- A. Every morning at shift change, thank each employee for an excellent job.
- B. Rotate a monthly "employee recognition award" among all employees on the unit.
- C. Wait until the annual performance review to recognize accomplishments.
- D. Give spur-of-the-moment recognition to an employee who has accomplished a goal.
Correct Answer: D
Rationale: The correct answer is D because giving spur-of-the-moment recognition to an employee who has accomplished a goal is an example of positive reinforcement. This action immediately follows the desired behavior, increasing the likelihood of it being repeated. This instant feedback helps reinforce the employee's behavior positively.
A: Thanking each employee every morning is a form of positive feedback, but it lacks the immediacy of reinforcement.
B: Rotating a monthly recognition award does not provide immediate reinforcement for specific behaviors.
C: Waiting for an annual review to recognize accomplishments does not provide timely feedback to reinforce desired behaviors.
A cultural phenomenon that is based on biologic variation would include:
- A. belief that exposure of a pregnant woman to an eclipse can result in cleft lip.
- B. denser bones in blacks result in less morbidity associated with osteoporosis.
- C. the grandmother who determines that her grandchild has scoliosis and should seek treatment, then informs the parents of her decision.
- D. a family that participates in feasts prepared to celebrate and make decisions.
Correct Answer: A
Rationale: The correct answer is A because it describes a cultural belief that attributes a physical trait (cleft lip) to a specific biological event (exposure to an eclipse during pregnancy). This choice demonstrates a cultural phenomenon based on biologic variation.
Choice B is incorrect because it attributes denser bones in blacks to less morbidity from osteoporosis, which is a generalization and not necessarily a cultural phenomenon. Choice C is incorrect as it describes a family dynamic related to healthcare decision-making and not a cultural belief based on biologic variation. Choice D is incorrect as it describes a family tradition related to feasting and decision-making, which does not directly involve biologic variation.
Hospitals surveyed nurses who terminated their employment to determine why they chose to leave. One of the most common reasons for leaving was:
- A. decreased pay for alternative shifts.
- B. that the nurse/patient ratio prevents safe care.
- C. that most facilities are choosing an all-RN staff, which decreases opportunities for advancement.
- D. that agency and foreign nurses are favored by administration over full-time nursing staff.
Correct Answer: B
Rationale: The correct answer is B: that the nurse/patient ratio prevents safe care. This answer is correct because inadequate nurse/patient ratios have been consistently identified as a major factor contributing to nurse dissatisfaction and burnout. When nurses are responsible for too many patients, they are unable to provide safe and effective care, leading to increased stress and job dissatisfaction.
Explanation of other choices:
A: Decreased pay for alternative shifts: While decreased pay may be a concern for some nurses, it is not typically cited as one of the most common reasons for leaving a position.
C: Most facilities are choosing an all-RN staff, which decreases opportunities for advancement: While this may be a concern for some nurses, it is not as universally impactful as unsafe nurse/patient ratios.
D: Agency and foreign nurses are favored by administration over full-time nursing staff: While favoritism may be an issue in some cases, it is not typically cited as one of the most common reasons for nurses leaving their employment.
Health care is one of the major stories in newspaper and television and a group of nurses are interested in how the economy impacts their nursing practice. The group critiques the relationship between contemporary economic trends and professional nursing practice and finds:
- A. the implementation of the DRG system led to the nursing shortage since cost of nursing care is not billed.
- B. nursing care is focused on technologically advanced acute care rather than preventive, patient-centered care.
- C. with pay for performance, nurses have a significant effect on the quality of patient outcomes by reducing errors and providing care based on best practices.
- D. economic issues have little or no impact on nursing practice.
Correct Answer: C
Rationale: The correct answer is C because pay for performance initiatives incentivize nurses to improve patient outcomes by reducing errors and following best practices. This directly links economic incentives to nursing practice. Choice A is incorrect because the DRG system primarily affects hospital reimbursement, not nursing shortages. Choice B is incorrect as it focuses on the type of care, not the economic impact on nursing practice. Choice D is incorrect as economic factors like funding, resources, and reimbursement significantly influence nursing practice.