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A nurse manager is working with the financial officer to develop the budget of the nursing unit for the next fiscal year. The nurse manager tells the financial officer that which of the following pieces of information will affect budget assumptions?
- A. The capital budget request for new emergency department equipment has been turned in for consideration by the hospital's administrative team.
- B. The patient census likely will increase during the next fiscal year because two large physician groups have transferred their admission privileges to this hospital.
- C. The participatory budgeting approach instituted last year has been helpful in controlling supply costs.
- D. Zero-based budgeting will help the managers to be more efficient in establishing next year's budget.
Correct Answer: B
Rationale: The correct answer is B because an increase in patient census directly impacts the budget assumptions by affecting staffing needs, supply costs, and revenue projections. This information is crucial for accurate budget planning.
Choice A is incorrect because the capital budget request for new equipment does not directly impact the nursing unit's operational budget assumptions.
Choice C is incorrect as the effectiveness of participatory budgeting in controlling supply costs does not directly influence future budget assumptions.
Choice D is incorrect as zero-based budgeting efficiency does not directly address the impact of increased patient census on budget assumptions.
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Which nurse best portrays nursing as a "knowledge worker"?
- A. Nurse in matched scrubs with lab coat, hair back, small stud earrings
- B. Nurse in mismatched scrubs, no lab coat, large hoop earrings
- C. Nurse in white uniform with apron with no jewelry/hair back
- D. Nurse with nose ring and eyebrow piercing with starched white uniform and cap
Correct Answer: A
Rationale: The correct answer is A because the nurse in matched scrubs with a lab coat and minimal jewelry portrays professionalism and adherence to safety standards. The lab coat signifies a commitment to infection control and respect for the clinical environment. The hair being pulled back ensures cleanliness and prevents hair from falling into a patient's wound. Small stud earrings are safe and do not pose a risk of injury to the nurse or patient.
Choice B is incorrect because mismatched scrubs and large hoop earrings may not reflect professionalism or attention to detail, which are crucial in nursing practice.
Choice C is incorrect as the nurse in a white uniform with apron and no jewelry may seem traditional but lacks the modern approach and attention to safety standards displayed by choice A.
Choice D is incorrect because the nurse with nose and eyebrow piercings, despite wearing a starched white uniform and cap, may not be perceived as a professional and may not adhere to conservative workplace standards.
The NCLEX examination is created and administered by the:
- A. American Association of Colleges of Nursing (AACN).
- B. American Nurses Association (ANA).
- C. National Council of State Boards of Nursing (NCSBN).
- D. National League for Nursing (NLN).
Correct Answer: C
Rationale: The correct answer is C: National Council of State Boards of Nursing (NCSBN). The NCLEX examination is developed and administered by the NCSBN, which is responsible for regulating nursing practice in the United States. They create the exam to ensure that nurses entering the profession meet minimum competency standards. The AACN (choice A) focuses on advancing nursing education, the ANA (choice B) is a professional organization representing nurses, and the NLN (choice D) is an organization that promotes excellence in nursing education. Therefore, the NCSBN is the only organization directly involved in the creation and administration of the NCLEX exam.
Regardless of the term used to describe high-quality health care, the focus of quality is:
- A. what the consumer needs and wants.
- B. economical care.
- C. having the greatest technologic advancement.
- D. services equally distributed among populations.
Correct Answer: A
Rationale: Step-by-step rationale for why choice A is correct:
1. Quality in healthcare should be consumer-centric, meeting their needs and preferences.
2. Consumer needs and wants drive patient satisfaction and outcomes.
3. Patient-centered care leads to better health outcomes and overall quality of care.
4. Focusing on consumer needs promotes individualized and effective care delivery.
Summary of why other choices are incorrect:
- Choice B (economical care) does not necessarily ensure high-quality care.
- Choice C (technologic advancement) is important but not the sole focus of quality healthcare.
- Choice D (equally distributed services) is important for equity but does not define quality in healthcare.
A nurse caring for a patient with anemia and heart failure prepares to hang a unit of packed red blood cells and realizes her break is in 5 minutes. She decides it is not necessary to have another nurse check the blood against the patient's information since the patient's blood type is O+ which she incorrectly remembered to be the universal donor. She hangs the blood, noting the patient is "reading and vital signs normal." She leaves the floor for her break and does not report leaving or ask anyone to perform required vital signs. Upon returning she meets a family friend who is visiting and time "just flies." She returns to the patient's room after admitting a new patient. The patient is hypotensive and color is cyanotic and anxious. She reports the findings to the charge nurse, who then contacts the physician. A blood reaction occurrence is noted. The nurse providing care is charged:
- A. with comparative negligence.
- B. with a preventable adverse event.
- C. with criminal negligence.
- D. under the doctrine of res ipsa loquitur.
Correct Answer: C
Rationale: The correct answer is C: with criminal negligence. The nurse displayed a reckless disregard for the patient's safety by not verifying the blood type, leaving for an extended break without ensuring proper monitoring, and failing to report her absence. These actions were highly irresponsible and demonstrated a severe lack of care and attention to the patient's well-being. Criminal negligence involves a conscious disregard for the consequences of one's actions, which in this case resulted in a serious adverse event for the patient. Choices A and B do not fully capture the gravity of the nurse's actions, as they imply a lesser degree of fault. Choice D, under the doctrine of res ipsa loquitur, would be inappropriate in this scenario as the nurse's actions directly contributed to the adverse outcome.
The Karnofsky prognostication scale is most appropriately used to screen patients with which medical diagnoses?
- A. Respiratory diseases
- B. Cancers
- C. Cardiac diseases
- D. AIDS
Correct Answer: D
Rationale: The Karnofsky Prognostication Scale is commonly used in patients with terminal illness, such as AIDS, to assess their functional status and predict their prognosis. Patients with AIDS often experience rapid decline in health, making this scale useful in determining their overall well-being and potential outcomes.
Incorrect choices:
A: Respiratory diseases - The Karnofsky scale is not commonly used for screening patients with respiratory diseases.
B: Cancers - While the Karnofsky scale can be used for cancer patients, it is most commonly associated with terminal illnesses like AIDS.
C: Cardiac diseases - The Karnofsky scale is not typically used for screening patients with cardiac diseases.