Nokea
In the triad of health care, which would be considered the third-party payer?
- A. Client
- B. Health care provider
- C. Insurance company
- D. Government agency that sets reimbursement rules for services
Correct Answer: C
Rationale: The correct answer is C: Insurance company. In the triad of health care, the third-party payer refers to an entity outside of the patient and health care provider that pays for the health care services. Insurance companies typically serve as third-party payers by covering a portion or all of the costs associated with medical treatments. The other choices (A, B, D) are not considered third-party payers in this context. Choice A refers to the client/patient receiving the health care services, choice B refers to the health care provider delivering the services, and choice D refers to a government agency that sets reimbursement rules but does not directly pay for the services rendered.
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A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed:
- A. honeymoon.
- B. shock or rejection.
- C. recovery.
- D. resolution.
Correct Answer: B
Rationale: The correct answer is B: shock or rejection. This phase of reality shock is characterized by feelings of being overwhelmed, confused, and unsure of how to proceed despite having knowledge. The novice nurse is experiencing a sense of rejection towards the situation due to the gap between theoretical knowledge and practical application. This phase is common among new healthcare professionals as they transition from academic learning to real-world clinical practice.
A: Honeymoon phase refers to the initial period of excitement and enthusiasm in a new role.
C: Recovery phase is when the individual starts to adapt and become more comfortable with the new role.
D: Resolution phase is the final stage where the individual fully integrates into the role and becomes confident and competent.
In this scenario, the novice nurse is clearly struggling and feeling overwhelmed, indicating that they are in the shock or rejection phase, making choice B the correct answer.
Which statements concerning licensure as a registered nurse are correct? (select all that apply)
- A. Nurses who graduate from different types of nursing education programs are granted different types of licenses, those with a baccalaureate degree having the most expanded role.
- B. A nursing license cannot be revoked, only suspended.
- C. Each nurse practice act describes requirements for initial licensure.
- D. It is illegal for states to ask about the mental or physical status of an applicant.
Correct Answer: A
Rationale: Rationale:
A: Correct. Nurses with different education levels (e.g., associate vs. bachelor's degree) have varied scope of practice. BSN-prepared nurses typically have a broader scope compared to ADN-prepared nurses.
B: Incorrect. Nursing licenses can be revoked or suspended for various reasons such as misconduct or negligence.
C: Incorrect. Nurse practice acts outline licensure requirements, but not specifically for initial licensure.
D: Incorrect. States may inquire about the mental or physical status of applicants to ensure they are fit to practice safely.
A nurse is interested in practicing in a faith-based community; when researching the role of the parish nurse, the nurse finds that:
- A. certification is available at a basic level after a qualifying examination is completed and a set number of practice hours have been worked, as defined by the state's nurse practice act.
- B. this advanced practice role focuses on health promotion and disease prevention.
- C. this role has no set standards or scope of practice but instead follows the doctrine of the denomination being served.
- D. this role is recognized by the American Nurses Association (ANA) as a specialty with a defined set of practice guidelines.
Correct Answer: B
Rationale: The correct answer is B because the role of a parish nurse primarily focuses on health promotion and disease prevention within a faith-based community. Parish nurses typically work to integrate spiritual care with traditional healthcare services. This choice aligns with the core responsibilities of a parish nurse and accurately reflects the primary focus of their practice.
Summary of other choices:
A: Incorrect. While certification may be available for parish nurses, the process and requirements are not solely defined by state regulations; it usually involves additional training in faith-based healthcare practices.
C: Incorrect. The role of a parish nurse is typically guided by professional standards and organizational protocols rather than being solely dictated by the doctrines of a specific denomination.
D: Incorrect. While the ANA may acknowledge the role of parish nursing, it does not have specific practice guidelines for this specialty.
Hospitals surveyed nurses who terminated their employment to determine why they chose to leave. One of the most common reasons for leaving was:
- A. decreased pay for alternative shifts.
- B. that the nurse/patient ratio prevents safe care.
- C. that most facilities are choosing an all-RN staff, which decreases opportunities for advancement.
- D. that agency and foreign nurses are favored by administration over full-time nursing staff.
Correct Answer: B
Rationale: The correct answer is B: that the nurse/patient ratio prevents safe care. This answer is correct because inadequate nurse/patient ratios have been consistently identified as a major factor contributing to nurse dissatisfaction and burnout. When nurses are responsible for too many patients, they are unable to provide safe and effective care, leading to increased stress and job dissatisfaction.
Explanation of other choices:
A: Decreased pay for alternative shifts: While decreased pay may be a concern for some nurses, it is not typically cited as one of the most common reasons for leaving a position.
C: Most facilities are choosing an all-RN staff, which decreases opportunities for advancement: While this may be a concern for some nurses, it is not as universally impactful as unsafe nurse/patient ratios.
D: Agency and foreign nurses are favored by administration over full-time nursing staff: While favoritism may be an issue in some cases, it is not typically cited as one of the most common reasons for nurses leaving their employment.
An RN makes the following assignments at the beginning of the shift. Which assignment would be considered high-risk delegation?
- A. A novice RN is assigned a patient with diabetes mellitus requiring mixing of regular and NPH insulin.
- B. An LPN is assigned an older adult with pneumonia and who requires dressing changes on a foot wound.
- C. An unlicensed assistive person is assigned the task of assisting a patient with late stages of Huntington's disease to ambulate a short distance in the hallway.
- D. A float RN from the oncology unit is assigned a patient with a white blood cell count of 4000 mm
Correct Answer: A
Rationale: The correct answer is A because it involves a high-risk delegation. Mixing insulin is a complex task that requires precise measurements and understanding of the patient's condition. A novice RN may lack the experience and knowledge to safely perform this task, leading to potential harm for the patient.
Choice B involves wound care, which is within an LPN's scope of practice and not as high-risk as insulin administration. Choice C involves basic ambulation assistance, which is appropriate for an unlicensed assistive person under supervision. Choice D involves caring for a patient with low white blood cell count, which may be challenging but not as high-risk as insulin mixing for a novice RN.