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A nurse researcher is attempting to describe the demographics of today's RNs and reports that:
- A. less than half of all RNs work in hospital settings.
- B. the average age for an RN is 50 years.
- C. approximately 25% of RNs are male.
- D. most RN are practicing with a bachelor's degree.
Correct Answer: A
Rationale: Correct Answer: A
Rationale: The correct answer is A because statistics show that currently, less than half of all registered nurses work in hospital settings, with the majority working in community, home health, long-term care, and other non-hospital settings. This information is supported by recent workforce studies and trends in nursing practice.
Summary of other choices:
B: The average age for an RN is not necessarily 50 years, as there is a wide range of ages among RNs, with many entering the profession at younger ages.
C: Approximately 25% of RNs are male, which is a significant proportion but does not encompass the majority of the nursing workforce.
D: While the number of RNs with bachelor's degrees is increasing, the majority of RNs still do not hold a bachelor's degree as their highest level of education.
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A client is admitted with chest pain. A series of diagnostic tests are ordered, and the client undergoes coronary artery bypass grafting. The cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (ICU) stay by 3 days because of respiratory problems. The case manager realizes that under the terms of the diagnosis-related group (DRG) payment system for this diagnosis:
- A. the cost of caring for this client was $5000 greater than the DRG reimbursement fee, and the hospital will be allowed to collect the additional fees from the insurance company.
- B. although the cost of care for this client was greater than the DRG reimbursement amount, the hospital will be reimbursed only at the set fee.
- C. the client will be sued to pay back the insurance company for the extra fees incurred because smoking is a modifiable health risk for heart disease.
- D. the physician who admitted the client will receive a reduced payment to cover the loss incurred by the hospital.
Correct Answer: B
Rationale: The correct answer is B. The DRG payment system is a fixed reimbursement amount for a specific diagnosis or procedure. In this case, the cost of care exceeded the DRG reimbursement amount due to the extended ICU stay caused by the client's smoking history. The hospital will only be reimbursed at the set fee specified by the DRG, regardless of the actual cost incurred.
Choice A is incorrect because the hospital cannot collect additional fees from the insurance company beyond the DRG reimbursement amount. Choice C is incorrect as the client is not typically held responsible for the additional costs incurred. Choice D is incorrect because physician payment is not directly impacted by the hospital's financial losses. The DRG system focuses on fixed reimbursements based on diagnoses, not individual physician payments.
A researcher is interested in learning if elderly persons perceive their health to be satisfactory even with comorbidities and chronic illness. A large multisite assistive living facility will be the site. The researcher lists residents in alphabetical order and chooses every third person on the list. To ensure improved generalizability, the researcher is using:
- A. triangulation.
- B. randomization.
- C. informed consent.
- D. a meta-analysis approach.
Correct Answer: B
Rationale: The correct answer is B: randomization. Randomization helps ensure improved generalizability by reducing bias and increasing the likelihood that the sample is representative of the population. In this scenario, choosing every third person from an alphabetical list introduces a systematic bias and may not represent the entire population accurately. Triangulation involves using multiple methods or data sources to validate findings, which is not applicable here. Informed consent is a necessary ethical consideration but does not directly impact generalizability. A meta-analysis approach involves combining and analyzing data from multiple studies, which is not relevant to the sampling method in this scenario. Thus, randomization is the best choice to improve generalizability in this study.
In differentiating between interprofessional and multidisciplinary:
- A. multidisciplinary refers to the care of many diverse patients by one discipline.
- B. interprofessional involves members of many disciplines working together to provide patient care to a distinct population.
- C. interprofessional refers to members of the same discipline working together to provide patient care to a distinct population.
- D. interprofessional is the use of multiple interventions by nurses with varying levels of education.
Correct Answer: B
Rationale: The correct answer is B because interprofessional involves members of different disciplines collaborating to provide patient care, promoting a holistic approach. This fosters shared decision-making and communication among healthcare professionals, leading to improved patient outcomes.
A is incorrect because multidisciplinary involves multiple disciplines treating a single patient, not many diverse patients.
C is incorrect because interprofessional involves different disciplines, not members of the same discipline working together.
D is incorrect because interprofessional is about collaboration between different disciplines, not the use of multiple interventions by nurses specifically.
A novice nurse is in the "rejection phase" of stress and wonders if she made the right decision when deciding nursing was her chosen career. Which strategy would help the novice nurse cope with transition into practice and reduce stress?
- A. When asked by the charge nurse to accept the new admission even though she had no discharges, the novice nurse stops and considers if this request is acceptable and safe, then accepts the assignment based on two patients having a low acuity level.
- B. Refusing to eat anywhere but the hospital cafeteria to ensure a balanced diet and time to socialize with other staff and visitors.
- C. Avoid wasting time by listening to coworkers' problems or ideas on how to staff the unit during the upcoming holiday since the novice nurse's time is valuable and better spent getting her own work completed.
- D. Make an effort to "win over" hostile or angry coworkers who find fault with the novice nurse's work performance.
Correct Answer: A
Rationale: The correct answer is A because it demonstrates a proactive and thoughtful approach to decision-making. By stopping to consider the request and assessing its safety implications before accepting it based on patient acuity levels, the novice nurse is prioritizing patient safety and her own capabilities. This strategy helps her cope with the transition into practice by promoting critical thinking and confidence in her decision-making skills.
Summary of why the other choices are incorrect:
B: Refusing to eat anywhere but the hospital cafeteria may lead to social isolation and restrict the novice nurse's ability to engage with others outside of work.
C: Ignoring coworkers' problems or staffing ideas can create a negative work environment and hinder teamwork, potentially increasing stress levels for the novice nurse.
D: Focusing on winning over hostile coworkers may detract from the novice nurse's professional growth and cause unnecessary stress from seeking validation from others.
During an admission history and physical, a female patient states, "I use 5000 mg/day of calcium to prevent osteoporosis and to maintain health." The nurse should assess for:
- A. excessive bleeding.
- B. kidney stones.
- C. lower blood sugar.
- D. jaundice.
Correct Answer: B
Rationale: The correct answer is B: kidney stones. High calcium intake increases the risk of kidney stones due to excess calcium being excreted in the urine. The nurse should assess for symptoms like flank pain, hematuria, and frequent urination. Excessive bleeding (choice A) is not directly related to high calcium intake. Lower blood sugar (choice C) and jaundice (choice D) are not typically associated with calcium intake.