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A patient with kyphosis is visiting a practitioner of chiropractic medicine for the first time and asks, "How does this therapy work?" The practitioner replies, "I will use my hands along with heat to correct the misalignment of your spine by placing pressure on the nerves that have produced pain. The misalignment of your spine is referred to as:
- A. subluxation."
- B. a sprain."
- C. a fracture."
- D. epicondylitis."
Correct Answer: A
Rationale: The correct answer is A: subluxation. Subluxation in chiropractic terms refers to the misalignment of the vertebrae in the spine, which can put pressure on nerves and cause pain. Chiropractors believe that by using manual adjustments, they can correct these subluxations and restore proper alignment, which can alleviate pain and improve overall health. The other choices, B: a sprain, C: a fracture, and D: epicondylitis, do not accurately describe the misalignment of the spine that is being addressed in chiropractic care. Sprain refers to ligament injury, fracture refers to bone breakage, and epicondylitis refers to inflammation of the tendons.
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A hospital's policy requires that all nurse managers must have a minimum of a bachelor's degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to physicians and staff, "The new nurse manager has book sense but no leadership abilities." What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit?
- A. Send memos to all staff except the upset nurse to invite them to a luncheon.
- B. Ask management to transfer the upset nurse to another unit.
- C. Assign the upset nurse to committees that do not directly affect that nursing unit.
- D. Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication.
Correct Answer: D
Rationale: Step 1: Acknowledge the clinical expertise of the upset nurse - This shows respect for the upset nurse's experience and expertise.
Step 2: Clearly explain the expectations for teamwork - Setting clear expectations fosters a collaborative environment.
Step 3: Emphasize open, honest communication - Encouraging open dialogue helps address concerns and build trust among the team.
Overall, option D is the best approach as it combines acknowledging the upset nurse's expertise, setting expectations for teamwork, and promoting open communication, which are crucial for gaining trust and respect among the nursing staff.
Summary of other choices:
A: Sending memos excludes the upset nurse and may create further resentment.
B: Transferring the upset nurse does not address the issue and may lead to more conflict.
C: Assigning the upset nurse to unrelated committees may isolate them and not address the underlying problem of lack of trust and respect on the unit.
Although a hospital reversed all charges when a client was the victim of wrong site surgery, the court awarded the client $5 million. The client was able to return to work in 6 weeks and had no permanent damages. This monetary compensation is termed:
- A. res ipsa loquitur.
- B. punitive damages.
- C. vicarious liability.
- D. immunity.
Correct Answer: B
Rationale: The correct answer is B: punitive damages. Punitive damages are awarded to punish the defendant for their wrongful actions. In this case, the hospital's negligence in performing wrong site surgery resulted in harm to the client, even though the hospital reversed the charges. The court awarded $5 million to punish the hospital for their negligence, as the client suffered emotional distress and the potential risk of harm. The other choices are incorrect because:
A: res ipsa loquitur is a legal doctrine used to shift the burden of proof from the plaintiff to the defendant in cases where the negligence is obvious.
C: vicarious liability holds an employer responsible for the actions of their employees, which is not directly applicable in this scenario.
D: immunity refers to protection from legal liability, which is not relevant in a case where the court awarded monetary compensation.
A nurse is preparing a scholarly publication on the prevalence of hepatitis A worldwide. The most efficient and effective means of conducting an Internet search to gather information for this publication is to use:
- A. a search engine such as Google or Yahoo.
- B. a consumer health website.
- C. a decision support system.
- D. MEDLINE database.
Correct Answer: D
Rationale: The correct answer is D: MEDLINE database. MEDLINE is a reputable database that provides access to a vast array of peer-reviewed medical literature, making it an excellent resource for scholarly publications. Here's the rationale:
1. Credibility: MEDLINE contains high-quality, peer-reviewed articles from reputable medical journals, ensuring the information obtained is reliable and accurate.
2. Specificity: The database is focused on medical research, including studies on hepatitis A, providing targeted and relevant information for the nurse's publication.
3. Efficiency: Search results in MEDLINE are organized and easily accessible, allowing the nurse to efficiently gather information without sifting through irrelevant sources.
4. Up-to-date: MEDLINE is regularly updated with the latest research findings, ensuring the nurse has access to the most current information on hepatitis A.
In summary, using MEDLINE is the best choice for the nurse as it offers credible, specific, efficient, and up-to-date information compared to the other options.
A nurse manager plans the fiscal budget to include salaries for two RNs for two 12-hour shifts with a patient census of 6 in the short-stay observation room. The nurse manager reviews the budget report 3 months later and notes that the salary expenses are higher than was budgeted because of higher-than-planned RN staff salaries. This additional RN staff is necessary to meet patient care needs because the census has remained constant at 10 patients rather than the 6 projected when the budget was developed. The difference between the planned budget and the actual cost is known as:
- A. revenue.
- B. variance.
- C. monitoring.
- D. capital expenditures.
Correct Answer: B
Rationale: The correct answer is B: variance. In this scenario, the nurse manager planned a budget based on a patient census of 6 but the actual census remained constant at 10, leading to higher-than-planned RN staff salaries. The difference between the planned budget and the actual cost is known as a variance. Variances help identify discrepancies between planned and actual expenses, enabling managers to adjust budgets accordingly. Revenue (A) refers to income generated, not the difference between planned and actual expenses. Monitoring (C) is the process of overseeing and evaluating activities, not specifically related to budget discrepancies. Capital expenditures (D) are long-term investments in assets, not related to budget variances.
An interdisciplinary team is evaluating the hospital's care of patients admitted with a myocardial infarction (heart attack) compared to national standards. The team analyzes the hospital's clinical indicator, which would be: (select all that apply)
- A. aspirin order within 24 hours of discharge.
- B. patient teaching related to stopping smoking completed prior to discharge.
- C. beta blocker administered upon arrival.
- D. support of employer to modify stress in workplace.
Correct Answer: A
Rationale: The correct answer is A: aspirin order within 24 hours of discharge. This is a key clinical indicator for evaluating care of heart attack patients as aspirin is a standard treatment to prevent further cardiac events. It is crucial for patient safety and adherence to national guidelines.
Choice B is incorrect as patient teaching on smoking cessation, although important, is not a direct clinical indicator for evaluating care of heart attack patients.
Choice C is incorrect as beta blocker administration upon arrival is important for heart attack patients, but it is not specific to evaluating the hospital's care compared to national standards.
Choice D is incorrect as employer support for stress modification is not a clinical indicator relevant to evaluating care of heart attack patients.