Nokea
Nurses in a unionized hospital are paid "compensatory pay" when working holidays equal to the number of hours worked with no extra compensation. Although they have suggested changes during the annual survey of employee satisfaction, management refuses to consider another system for compensatory pay. A trained member listened to both nurses and management to make recommendations that were not legally binding. This type of settlement is termed:
- A. picketing.
- B. binding arbitration.
- C. mediation.
- D. grievance.
Correct Answer: C
Rationale: The correct answer is C: mediation. In this scenario, a trained member listened to both parties (nurses and management) and made recommendations that were not legally binding. Mediation involves a neutral third party facilitating communication and negotiation between conflicting parties to help them reach a mutually acceptable resolution. It is non-binding, unlike binding arbitration, where a decision is imposed on the parties. Picketing involves organized striking by employees to protest against employer practices. Grievance is a formal complaint process within an organization. Mediation is the appropriate term for this non-binding settlement process in this context.
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A person who is covered by Medicaid moves from one state to another and asks the nurse at the health department why the benefits changed. The correct response by the nurse is:
- A. "Local government controls which benefits each county can provide to Medicaid recipients."
- B. "The federal government does not fund any part of Medicaid, so each state must find ways to pay for benefits."
- C. "Each state determines benefits on the basis of the present economy."
- D. "Medicaid is funded by both state and federal governments, but benefits vary from state to state."
Correct Answer: D
Rationale: The correct answer is D: "Medicaid is funded by both state and federal governments, but benefits vary from state to state."
Rationale:
1. Medicaid is a joint federal and state program, meaning it is funded by both levels of government.
2. States have flexibility in designing and administering their Medicaid programs, leading to variations in benefits across states.
3. When an individual covered by Medicaid moves to a different state, they may experience changes in benefits due to these state-specific variations.
Summary:
A: Incorrect. While local governments may have some influence, Medicaid is primarily funded by both state and federal governments.
B: Incorrect. The federal government does provide funding for Medicaid, but states also contribute, and benefits do vary across states.
C: Incorrect. State benefits under Medicaid are not solely determined by the present economy; they are influenced by various factors and state policies.
A registered nurse is on break and checking e-mails. One e-mail contains a picture of a celebrity who is a patient in the hospital, and on the same floor, where the nurse works. Included with the photo is a message, "check out my Facebook," which contains additional photographs of the patient. The nurse immediately deletes the picture to prevent having to report the "friend" to supervisors. Based on the action of the nurse who received the message, which statement is correct?
- A. The nurse is not at risk for having his or her license suspended since removing the photos made them temporary and invisible to all others.
- B. Because the nurse did not send the message and immediately deleted the photo, there is no risk for discipline.
- C. Failing to report receiving the message demonstrates poor ethical and legal role-modeling as well as placing the nurse at risk for discipline.
- D. Because the patient is on the same floor as the one on which the nurse works, the information can be ethically and legally shared.
Correct Answer: C
Rationale: The correct answer is C. The nurse is at risk for discipline because failing to report the receipt of the message demonstrates poor ethical and legal role-modeling. By deleting the photo and not reporting the incident, the nurse is not upholding patient confidentiality and is potentially violating privacy laws. Sharing patient information, even if the patient is on the same floor, is unethical and illegal. Choices A and B are incorrect because simply deleting the photos does not absolve the nurse from potential consequences, and not being the sender does not excuse the nurse from being responsible for maintaining patient confidentiality. Choice D is incorrect because sharing patient information without authorization is a violation of ethical and legal standards.
Nurses caring for the victims of a mass casualty incident:
- A. determine the common terminology to be used by hospitals and participating agencies.
- B. take charge of communicating with the news media.
- C. determine whether there is a credible threat of a terrorist attack.
- D. give priority for care to those with the greatest chance of survival rather than those most critically ill.
Correct Answer: D
Rationale: The correct answer is D because prioritizing care based on the greatest chance of survival maximizes the number of lives saved in a mass casualty incident. This approach follows the principle of triage, which aims to allocate resources efficiently. Choice A is incorrect as it pertains to coordination rather than immediate patient care. Choice B is incorrect as it is not the primary role of nurses during a mass casualty incident. Choice C is incorrect as determining a credible threat is the responsibility of security and law enforcement, not nurses.
During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy?
- A. An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway.
- B. A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power.
- C. A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call.
- D. A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.
Correct Answer: A
Rationale: The correct answer is A because denying the older person with Alzheimer's disease the right to ambulate violates their autonomy by restricting their freedom to make choices about their own body and movement. Autonomy is the ethical principle that respects an individual's right to make decisions about their own health and well-being. In this situation, the person should have the autonomy to decide whether or not they want to ambulate, even if they have advanced Alzheimer's disease.
Choice B is incorrect because the mentally competent adult has the right to refuse medical treatment based on their beliefs, which is an expression of autonomy.
Choice C is incorrect because the mentally competent visitor has the right to refuse examination, which is also an expression of autonomy.
Choice D is incorrect because the mentally competent adult has the right to refuse a local anesthetic, which is also an expression of autonomy.
A student is planning to enroll in prerequisite courses after graduating from high school and is researching options for nursing programs. During a career fair the student compares different types of nursing education programs and discovers that:
- A. diploma programs focus on family and community, with an emphasis on health promotion.
- B. most practicing RNs graduated from diploma programs because this was the first type of RN program.
- C. baccalaureate programs focus on technical and hands-on nursing skills in diverse community settings.
- D. master's programs such as that for the clinical nurse leader provide entry into practice with a focus on interdisciplinary and bedside nursing care for complex client populations.
Correct Answer: D
Rationale: The correct answer is D because master's programs, like the one for clinical nurse leaders, indeed provide entry into practice with a focus on interdisciplinary and bedside nursing care for complex client populations. This choice stands out as it specifically addresses the advanced level of education and specialization required for handling complex cases.
Choice A is incorrect because diploma programs typically focus on basic nursing skills rather than specialization in complex client populations.
Choice B is incorrect as most practicing RNs nowadays graduate from associate's or bachelor's degree programs, not diploma programs.
Choice C is incorrect because baccalaureate programs emphasize a broader education including leadership, research, and critical thinking skills rather than just technical and hands-on nursing skills.