Nokea
Health care is one of the major stories in newspaper and television and a group of nurses are interested in how the economy impacts their nursing practice. The group critiques the relationship between contemporary economic trends and professional nursing practice and finds:
- A. the implementation of the DRG system led to the nursing shortage since cost of nursing care is not billed.
- B. nursing care is focused on technologically advanced acute care rather than preventive, patient-centered care.
- C. with pay for performance, nurses have a significant effect on the quality of patient outcomes by reducing errors and providing care based on best practices.
- D. economic issues have little or no impact on nursing practice.
Correct Answer: C
Rationale: The correct answer is C because pay for performance initiatives incentivize nurses to improve patient outcomes by reducing errors and following best practices. This directly links economic incentives to nursing practice. Choice A is incorrect because the DRG system primarily affects hospital reimbursement, not nursing shortages. Choice B is incorrect as it focuses on the type of care, not the economic impact on nursing practice. Choice D is incorrect as economic factors like funding, resources, and reimbursement significantly influence nursing practice.
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Registered nurses who are entering the workforce will have expanded leadership responsibilities that include: (select all that apply)
- A. serving on interdisciplinary care teams.
- B. being competent to work in several areas independently when dictated by patient census.
- C. attending a meeting to plan advanced training for unlicensed assistive personnel.
- D. evaluating outcomes of care that are reported to a standing committee.
Correct Answer: A
Rationale: The correct answer is A: serving on interdisciplinary care teams. This is correct because as registered nurses enter the workforce, they are expected to collaborate with other healthcare professionals on interdisciplinary care teams to provide comprehensive patient care. This involves working together with professionals from different disciplines to ensure holistic and effective treatment plans.
Explanation for why the other choices are incorrect:
B: Being competent to work in several areas independently when dictated by patient census - While nurses may need to be versatile, the emphasis on independent work in various areas does not necessarily reflect expanded leadership responsibilities.
C: Attending a meeting to plan advanced training for unlicensed assistive personnel - While important for team collaboration, attending meetings to plan training for support staff does not directly relate to expanded leadership responsibilities.
D: Evaluating outcomes of care that are reported to a standing committee - While evaluating outcomes is important, it may not specifically denote expanded leadership responsibilities compared to the collaborative nature of serving on interdisciplinary care teams.
When practicing in a compact state:
- A. the nurse must abide solely by the practice act of the largest state.
- B. patients' rights in relation to the nurse practice act are protected by the mutual recognition model.
- C. the nurse must pay for a license in all states that participate in the mutual recognition model.
- D. the nurse must refer to the nurse practice act for the list of skills that can be performed.
Correct Answer: B
Rationale: The correct answer is B because in a compact state, the mutual recognition model allows nurses to practice across state lines without obtaining additional licenses. This model ensures that patients' rights are protected by requiring nurses to adhere to the nurse practice act of the state where the patient is located. This promotes nursing mobility while maintaining regulatory standards.
A is incorrect because nurses must follow the nurse practice act of the state where they are practicing, not necessarily the largest state. C is incorrect because nurses do not have to pay for a license in all participating states under the mutual recognition model. D is incorrect because the nurse practice act outlines the scope of practice, not necessarily the list of skills that can be performed across state lines.
An RN is counseled by the nurse manager regarding inappropriate delegation when the:
- A. RN instructs the nursing assistant to greet ambulatory surgery patients and show them to their rooms.
- B. nursing assistant informs the RN that she has not been trained to collect a sputum specimen and the RN states, "I will show you this time and you can show me the next time."
- C. RN assigns the float LPN/LVN the task of completing a plan of care for a stable patient who was admitted for routine replacement of a feeding tube.
- D. LPN/LVN who has demonstrated competence is asked to perform a dressing change for a patient before she is discharged home.
Correct Answer: C
Rationale: The correct answer is C because delegating the task of completing a plan of care to a float LPN/LVN for a stable patient is inappropriate. LPNs/LVNs have a different scope of practice compared to RNs and should not be assigned tasks related to developing care plans. This task requires critical thinking skills and assessment that are within the RN's scope of practice.
A: A is incorrect because delegating the task of greeting and showing ambulatory surgery patients to their rooms is appropriate for a nursing assistant.
B: B is incorrect because delegating the task of collecting a sputum specimen, once trained, is appropriate for a nursing assistant under the supervision of an RN.
D: D is incorrect because delegating the task of performing a dressing change to a competent LPN/LVN is appropriate, as long as it falls within their scope of practice.
If a nurse applies Nightingale's theory to current practice, the nurse's first step will be to evaluate the hospital room's air quality and, second, to:
- A. make certain that the volume of the television is not too loud.
- B. consult the dietitian to check that essential nutrients are added to meet requirements noted on MyPyramid.
- C. ask the client's family to bring family photographs and bright-colored throws for the bed.
- D. arrange for the client to go outside, weather permitting, while keeping the room's window blinds open.
Correct Answer: D
Rationale: The correct answer is D because Nightingale's theory emphasizes the importance of a clean and well-ventilated environment for patient healing. By arranging for the client to go outside and keeping the room's window blinds open, the nurse is ensuring proper ventilation and exposure to natural light, which can promote healing. This step aligns with Nightingale's focus on the physical environment's impact on health outcomes.
A, B, and C are incorrect because they do not directly address the fundamental principle of Nightingale's theory related to environmental factors. Checking the TV volume, consulting a dietitian, or bringing personal items like family photographs do not directly contribute to creating a healing environment based on Nightingale's theory.
During a search for the term informatics, when the nurse finds the domain ".edu," the site is affiliated with a(n):
- A. government agency.
- B. commercial site.
- C. educational institution
- D. Internet service provider.
Correct Answer: C
Rationale: The correct answer is C: educational institution. ".edu" domain is reserved for educational institutions in the United States, indicating that the website is affiliated with an educational organization. Government agencies typically use ".gov" domain (A), commercial sites use ".com" domain (B), and Internet service providers use ".net" domain (D). Therefore, the presence of ".edu" in the domain indicates that the site is associated with an educational institution.