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A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency?
- A. Safety
- B. Timely
- C. Equitable
- D. Patient-centered care
Correct Answer: A
Rationale: The correct answer is A: Safety. The team of nurses developing algorithms and checklists aims to ensure standardization of procedures, which directly relates to patient safety. Safety is a fundamental competency in healthcare, as it involves minimizing harm to patients. Standardization through checklists helps reduce errors and promote consistency in care delivery. Timely care (B) focuses on providing care promptly, equitable care (C) emphasizes fairness and eliminating disparities, and patient-centered care (D) prioritizes individual preferences and needs. While these competencies are important in healthcare, in this scenario, the team's primary focus on standardization aligns with the safety competency.
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A patient is upset because her health insurance plan refused to pay for a mammogram and services by a women's health specialist because the primary care physician did not order the referral or the mammogram. Which type of insurance plan adheres to this type of payment system?
- A. Fee for Service
- B. Health Maintenance Organization (HMO)
- C. Preferred Provider Organization (PPO)
- D. Point of Service (POS)
Correct Answer: B
Rationale: The correct answer is B: Health Maintenance Organization (HMO). In an HMO, services are typically provided by a primary care physician who acts as a gatekeeper for all medical services, including referrals to specialists and diagnostic tests like mammograms. The primary care physician must authorize and order these services for them to be covered by the insurance plan. This system helps control costs and ensures coordinated care.
A: Fee for Service does not require a primary care physician to authorize referrals or services.
C: PPO allows patients to see out-of-network providers without referrals.
D: POS plans offer more flexibility in choosing healthcare providers without requiring a primary care physician's referral.
A family requests that no additional heroic measures be instituted for their terminally ill mother who has advance directives in place. The nurse respects this decision in keeping with the principle of:
- A. accountability.
- B. autonomy.
- C. nonmaleficence.
- D. veracity.
Correct Answer: B
Rationale: The correct answer is B: autonomy. Autonomy refers to respecting the right of individuals to make their own decisions about their healthcare. In this scenario, the family's request to honor the terminally ill mother's advance directives aligns with the principle of autonomy as it acknowledges her right to make decisions about her own care. Accountability (A) pertains to taking responsibility for one's actions, nonmaleficence (C) involves avoiding harm, and veracity (D) refers to truthfulness. While these principles are important in healthcare, in this specific case, autonomy takes precedence as it respects the patient's wishes.
A graduate is preparing for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination. Based on the latest practice survey, the candidate would focus the most amount of time on which content?
- A. Stages of grief
- B. Pharmacologic pain management
- C. Practices to promote rest and sleep
- D. Prioritization of workload to manage time effectively
Correct Answer: B
Rationale: The correct answer is B: Pharmacologic pain management. This is the most important content area to focus on for the NCLEX-RN exam because pain management is a critical aspect of nursing care. Nurses must understand different types of pain, medications used for pain management, side effects, and assessment techniques. Pharmacologic pain management directly impacts patient comfort and quality of care.
Rationale:
1. Pain management is a fundamental aspect of nursing care.
2. Pharmacologic pain management knowledge is crucial for safe and effective patient care.
3. NCLEX commonly tests on pharmacological interventions and their implications.
4. Understanding pain management aligns with nursing scope of practice and ethical responsibilities.
Other Choices:
A: Stages of grief - While important in nursing, this topic is not as high-priority for the NCLEX-RN exam.
C: Practices to promote rest and sleep - Important, but not as directly related to pharmacological interventions.
D: Prioritization of workload to manage time effectively - Relevant
Which of the following situations would be appropriate for the supervisory level of initial direction and/or periodic inspection?
- A. Experienced RNs work together to provide care for a group of patients newly diagnosed with meningitis.
- B. The RN assigns the LPN tasks within her scope of practice and checks back during the shift to ensure the tasks are completed correctly.
- C. A new graduate nurse is assigned care to a male patient with a hematocrit of 11.0 g of hemoglobin per deciliter and is receiving a blood transfusion. The charge nurse checks on the patient status every 15 to 30 minutes and asks the graduate to explain "next steps."
- D. No supervision is necessary since both are registered nurses.
Correct Answer: B
Rationale: The correct answer is B because the scenario describes a situation appropriate for the supervisory level of initial direction and periodic inspection. The RN assigning tasks to the LPN within her scope of practice and checking back ensures tasks are completed correctly, aligning with the supervisory role. This level of oversight is necessary for safe and effective patient care.
Choice A is incorrect as experienced RNs working together do not require supervisory direction for caring for patients. Choice C involves the charge nurse providing frequent oversight to a new graduate nurse, which is more than just periodic inspection. Choice D is incorrect because regardless of both being registered nurses, supervision may still be necessary, especially when assigning tasks to a different level of healthcare provider like an LPN.
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.