An advanced practice nurse inputs into a computer software program the following clinical manifestations: open wound with tibia exposed, petechial hemorrhage, and temporary loss of consciousness. The computer diagnosis of fat emboli is generated by a system known as:
- A. decision support.
- B. telehealth.
- C. robotic technology.
- D. biometric technology.
Correct Answer: A
Rationale: The correct answer is A: decision support. In this scenario, the nurse inputs clinical manifestations into a computer program to assist in generating a diagnosis. Decision support systems use algorithms and data to provide healthcare professionals with evidence-based recommendations or diagnoses. In this case, the system likely recognized the combination of clinical signs as indicative of fat emboli. Telehealth (B) involves remote healthcare services, not diagnosis. Robotic technology (C) and biometric technology (D) are not directly related to clinical diagnosis like decision support systems are.
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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.
When an RN is asked to accept an assignment that he or she may not be qualified to perform, the nurse should:
- A. accept the assignment as appropriate if assigned by a legitimate power.
- B. be primarily concerned with the number of patients being assigned.
- C. ask how other nurses have handled the assignment in the past.
- D. determine whether he or she is familiar with the types of patients being assigned.
Correct Answer: D
Rationale: Step-by-step rationale for why Answer D is correct:
1. Ensures patient safety: RN should only accept assignments they are qualified for to provide safe care.
2. Upholds professional standards: Accepting only familiar assignments aligns with nursing scope of practice.
3. Legal and ethical responsibility: RN must prioritize patient well-being over external pressures.
4. Promotes personal growth: RN can seek additional training for unfamiliar assignments.
Summary:
- A: Incorrect. Accepting based on power dynamics disregards patient safety and professional ethics.
- B: Incorrect. Patient safety should be the primary concern over workload.
- C: Incorrect. Past handling may not guarantee appropriateness. Focus should be on personal qualification.
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.
A group of RNs wish to seek union representation that would protect all workers in the agency including nonlicensed assistive personnel and non-nursing employees such as nutritionists and dietary workers. The type of union being sought is the strongest collective group and is known as a(n):
- A. occupational union.
- B. industrial union.
- C. union shop.
- D. right-to-work bargaining organization.
Correct Answer: B
Rationale: The correct answer is B: industrial union. Industrial unions represent all workers in a particular industry regardless of their specific job roles, providing collective bargaining power for a broader group. In this scenario, the RNs seeking union representation aim to include nonlicensed personnel and non-nursing employees, making an industrial union the most appropriate choice.
A: Occupational union focuses on specific occupational groups, not as inclusive as industrial unions.
C: Union shop refers to a workplace where all employees must join the union after being hired, not related to the scope of representation.
D: Right-to-work bargaining organization allows employees to choose whether or not to join the union, not the strongest type of union for collective representation.
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.