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A nurse is very interested in learning more about health care economics and how she can use that knowledge to become a better patient advocate. She comments, "Nurses should not only deliver care one day at a time in one facility but should coordinate patient care as they move from acute care to rehabilitation to home care." This nurse would be a candidate for which nursing role?
- A. Disease management program (DMP) for chronic illnesses
- B. A hospital-based utilization management nurse who reviews medical records to determine the most appropriate DRG for patients
- C. Case management
- D. Reviewer for Managed Care Organization
Correct Answer: C
Rationale: Rationale:
1. The nurse's interest in coordinating patient care across different settings aligns with the role of a case manager.
2. Case managers focus on ensuring continuity of care and coordinating services for patients transitioning between different healthcare settings.
3. This role involves advocating for patients' needs and optimizing their health outcomes through seamless care transitions.
Summary:
A: DMP focuses on managing chronic illnesses, not coordinating care across settings.
B: Utilization management nurses focus on determining appropriate reimbursement levels, not on care coordination.
D: Reviewers for Managed Care Organizations focus on assessing medical necessity and cost-effectiveness, not on care coordination.
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Nurses can combat the nursing shortage by:
- A. joining unions, which influence employers to provide incentives such as pay raises and free child care, thus encouraging the large percentage of nonworking nurses to return to the workforce.
- B. demanding that the requirements of the qualifying examination for foreign nurses should be reduced, so they are eligible to sit for the licensure examination.
- C. working more hours with a higher nurse/patient ratio.
- D. advocating for funds to pay for nursing education and a safer work environment.
Correct Answer: D
Rationale: The correct answer is D because advocating for funds to pay for nursing education and a safer work environment addresses the root causes of the nursing shortage. By securing funding for education, more individuals can enter the nursing profession. Creating a safer work environment enhances nurse retention.
A is incorrect because while unions can negotiate for better benefits, it doesn't directly address the shortage by increasing the number of nurses.
B is incorrect because reducing the requirements for foreign nurses may compromise the quality of care and does not address the shortage of local nurses.
C is incorrect because working more hours with a higher nurse/patient ratio can lead to burnout and compromise patient safety, exacerbating the nursing shortage.
A patient is brought to the unit with mediastinal chest tubes with no fluctuation in the water seal chamber; arterial blood gas results reveal pH, 55; CO , 55; HCO, 28 mEq/L, and O , 98%. Carotid artery pulsation is visible with the head of the bed elevated and the use of tangential lighting. The first action of the nurse is to: The above question represents which level of Bloom's taxonomy?
- A. Knowledge
- B. Comprehension
- C. Application
- D. Analysis
Correct Answer: C
Rationale: The correct answer is C: Application. In this scenario, the nurse needs to apply knowledge of arterial blood gas results and assessment findings to determine appropriate actions. With the patient having abnormal ABG results and visible carotid artery pulsation, the nurse must recognize impending respiratory failure and act promptly, such as notifying the healthcare provider or respiratory therapist. This requires applying critical thinking skills to make decisions based on collected data.
Incorrect choices:
A: Knowledge - Choosing this option implies only recalling facts, which is not sufficient in this situation.
B: Comprehension - This choice suggests understanding the information given, but it does not involve applying that understanding to make decisions.
D: Analysis - While analysis involves breaking down information, the immediate action needed in this case is more about applying knowledge to prevent a potential crisis, rather than deeply analyzing the situation.
A nurse who is participating in a health fair asks, "Other than nursing, what are some opportunities for careers in the health care professions, and what education is required?" The nurse informs participants that a baccalaureate degree is required as the minimum standard for the role of:
- A. speech therapist.
- B. occupational therapist.
- C. nurse-midwife.
- D. nurse anesthetist.
Correct Answer: D
Rationale: The correct answer is D: nurse anesthetist. Nurse anesthetists require a minimum of a baccalaureate degree in nursing as a prerequisite for their advanced practice role. They then need to complete a master's or doctoral program in nurse anesthesia. This advanced education and training enable nurse anesthetists to provide anesthesia care in various healthcare settings.
Incorrect answers:
A: Speech therapists require a master's degree in speech-language pathology.
B: Occupational therapists require a master's degree in occupational therapy.
C: Nurse-midwives require a master's degree in nurse-midwifery or a related field.
In summary, the minimum education requirement of a baccalaureate degree aligns with the role of a nurse anesthetist, making choice D the correct answer.
A contractual agreement between the insurer and the provider in which covered members are encouraged to use specific health care providers in return for reduced rates is which type of arrangement?
- A. Health maintenance organization
- B. Preferred provider organization
- C. Fee-for-service arrangement
- D. Philanthropic agency
Correct Answer: B
Rationale: The correct answer is B: Preferred provider organization (PPO). PPOs offer reduced rates to covered members who use specific healthcare providers within their network. This arrangement incentivizes members to choose in-network providers, resulting in cost savings for both the insurer and the member. In contrast, A (Health maintenance organization) focuses on preventive care and requires members to select a primary care physician, C (Fee-for-service arrangement) allows members to choose any provider with varying reimbursement rates, and D (Philanthropic agency) is not related to health insurance arrangements.
An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision?
- A. There is no supervision, because at times the LPN/LVN is not with the RN.
- B. Periodic inspection is being used. Because the LPN/LVN is licensed, the RN is relieved of the need to evaluate care.
- C. Continual supervision is being provided until the RN determines competency.
- D. Initial supervision is being provided because this is the LPN/LVN's first day on the unit.
Correct Answer: C
Rationale: The correct answer is C: Continual supervision is being provided until the RN determines competency.
Rationale:
1. Continual supervision is necessary for the LPN/LVN on the first day to assess their competency.
2. The RN checks frequently throughout the shift to provide support and evaluate the LPN/LVN's performance.
3. Competency must be determined before reducing supervision levels.
4. This level of supervision ensures patient safety and quality care.
Incorrect choices:
A: There is no supervision - Incorrect because supervision is provided by the RN.
B: Periodic inspection - Incorrect as continual supervision is needed for competency assessment.
D: Initial supervision - Incorrect as supervision should continue until competency is established.
In summary, choice C is correct as continual supervision is crucial for the LPN/LVN on their first day to ensure patient safety and quality care.