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A nurse is concerned because novice nurses are having their orientation period shortened and are being placed in charge nurse positions. The nurse has documented unsafe care and decisions by these novice nurses. To be protected from retaliation by the employer, this nurse must "blow the whistle" by:
- A. holding a public forum in the agency cafeteria to discuss concerns.
- B. reporting concerns to state and/or national agencies regulating the agency.
- C. calling coworkers outside the workplace to informally discuss wrongdoing.
- D. contacting The Joint Commission to report unsafe conditions.
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. Reporting concerns to state and/or national agencies is a formal and official way to blow the whistle.
2. State and national agencies have the authority to investigate and take action on reported concerns.
3. Whistleblower protection laws often cover individuals who report to regulatory agencies.
4. This action ensures the concerns are addressed at a higher level and can protect the nurse from retaliation.
Summary of why the other choices are incorrect:
A. Holding a public forum may not provide the necessary confidentiality or protection for the nurse.
C. Informally discussing wrongdoing with coworkers may not result in formal actions to address the concerns.
D. Contacting The Joint Commission is a good option, but reporting concerns to state and/or national agencies is more direct and appropriate in this scenario.
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A community in the New Madrid fault zone experiences an earthquake resulting in injuries from propelled objects and abrasions for many victims. The local supply of antibiotics is quickly exhausted. Local authorities would contact the:
- A. Commissioned Corps Readiness Force.
- B. Strategic National Stockpile.
- C. Department of Homeland Security.
- D. local Young Men's Christian Association (YMCA).
Correct Answer: B
Rationale: The correct answer is B: Strategic National Stockpile. This is because the Strategic National Stockpile is a federal repository of antibiotics, medical supplies, and equipment to respond to public health emergencies. In this scenario, the local supply of antibiotics is exhausted, so contacting the Strategic National Stockpile would provide the necessary antibiotics to treat the injured victims.
Explanation for why other choices are incorrect:
A: The Commissioned Corps Readiness Force is a team of health professionals who can be deployed during public health emergencies, but they do not specifically store or distribute medical supplies like antibiotics.
C: The Department of Homeland Security focuses on national security and disaster response, but they do not directly handle the distribution of medical supplies like antibiotics.
D: The local Young Men's Christian Association (YMCA) is a community organization that is not equipped to provide medical supplies for emergency response situations like this earthquake scenario.
A director of nursing (DON) asks the staff to list how their nursing unit can help the organization meet its goal to "provide quality patient care with attention to compassion and excellence." An ad hoc committee is formed to develop a timeline of identified actions. The DON coaches the committee to reach desired outcomes. This DON is demonstrating which other role of leadership and management?
- A. Transactional
- B. Clinical consultant
- C. Corporate supporter
- D. Autocratic
Correct Answer: B
Rationale: The correct answer is B: Clinical consultant. In this scenario, the DON is providing guidance and expertise to the ad hoc committee in developing strategies to meet the organization's goal of providing quality patient care. As a clinical consultant, the DON utilizes their clinical knowledge and experience to coach and support the committee in achieving desired outcomes related to patient care. The other choices are incorrect because:
A: Transactional leadership focuses on exchanging rewards for performance and does not align with the DON's role in providing clinical guidance.
C: Corporate supporter role involves advocating for organizational goals at a higher level and is not directly related to coaching a committee on clinical matters.
D: Autocratic leadership style is characterized by making decisions without input from others, which is not demonstrated in the scenario where the DON is coaching and guiding the committee.
A new nurse asks, "Since Electronic Medical Records can improve quality care by having seamless data available for a patient, why doesn't everyone just replace paper and pencil charts"? Barriers to a universal health information infrastructure include the fact that: (select all that apply)
- A. competition from individual companies to build EMR prevent a universal infrastructure.
- B. cost is prohibitive even with federal funding for larger health care systems.
- C. preventive health reminders for immunizations and yearly screenings such as mammograms are used in clinical decision making.
- D. insurance companies have halted sharing of some patient data due to fear of law suits.
Correct Answer: A
Rationale: The correct answer is A because competition from individual companies to build EMR prevents a universal infrastructure. This is because different EMR systems may not be compatible with each other, hindering seamless data sharing.
Choice B is incorrect because while cost can be a barrier, federal funding can help mitigate this issue for larger healthcare systems. Choice C is incorrect because preventive health reminders are a benefit of EMR, not a barrier. Choice D is incorrect because insurance companies' fear of lawsuits does not directly impact the establishment of a universal health information infrastructure.
A nurse is listening to a patient's apical heart rate. The patient asks, "Is everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is demonstrating:
- A. open communication.
- B. filtration.
- C. blocking.
- D. false assurance.
Correct Answer: D
Rationale: The correct answer is D: false assurance. By not providing a verbal response to the patient's question and shrugging her shoulders, the nurse is not giving any indication of the patient's actual condition. This lack of communication can lead the patient to interpret the nurse's actions as reassurance that everything is fine, which is a form of false assurance. This behavior can be misleading and may prevent the patient from receiving important information about their health status.
Incorrect choices:
A: open communication - The nurse's lack of verbal response and shrugging shoulders does not demonstrate open communication.
B: filtration - Filtration is not relevant to the situation described.
C: blocking - While the nurse is not providing necessary information, the term "blocking" does not accurately describe the situation.
A nurse manager is preparing a budget that does not base annual budgets on the revenue and expenditures of the prior year and has the advantage that outdated information is not integrated into the budget. The manager is using which budget method?
- A. Zero-based
- B. Incremental
- C. Labor
- D. Operational
Correct Answer:
Rationale: Correct Answer: A: Zero-based
Rationale:
1. Zero-based budgeting starts from scratch, evaluating each expense regardless of the prior year.
2. It helps eliminate inefficiencies and ensures resources are allocated to high-priority areas.
3. By not relying on past data, outdated information does not influence the budget decisions.
Summary:
B: Incremental budgeting builds on the previous year's budget, not starting from zero.
C: Labor budget focuses specifically on labor costs, not the overall budgeting approach.
D: Operational budget typically considers historical data and current operations, unlike zero-based budgeting.