Nokea
Nurses on a unit met with the nurse manager as part of participatory budgeting. They ask, "What exactly is the difference between fixed and variable costs? Understanding this will help us better understand the budgeting process." The manager provides a definition and asks the staff to list types of direct and indirect cost. Which example would indicate a need for further teaching?
- A. Fixed costs would include accreditation fees.
- B. Fixed cost would include the cost for the automated medication-dispensing system.
- C. Variable cost would include the nurse manager's salary.
- D. Variable cost would include the salary expense for registered nurses.
Correct Answer: C
Rationale: The correct answer is C because the nurse manager's salary is typically considered a fixed cost, not a variable cost. Fixed costs remain constant regardless of the level of production or activity, while variable costs change in direct proportion to the level of activity. The nurse manager's salary is a fixed cost because it remains the same regardless of how many nurses are employed or how many patients are being cared for.
A: Fixed costs such as accreditation fees are correct examples.
B: Fixed costs like the cost for the automated medication-dispensing system are also correct examples.
D: Variable costs like the salary expense for registered nurses are correct examples.
Therefore, choice C would indicate a need for further teaching as it misidentifies the nurse manager's salary as a variable cost when it should be classified as a fixed cost.
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A client asks the nurse, "Can you explain Medicare, an amendment to the Social Security Act?" The nurse responds that Medicare:
- A. led to many hospital closings, along with a decrease in acute care hospital's based nursing care.
- B. provided medical insurance to those younger adults or children who were not eligible for private insurance because of catastrophic illnesses such as cancer.
- C. provided preventive care for women, infants, and children.
- D. ensured that individuals ages 65 and older and those with end-stage renal disease or permanent disabilities had health care insurance.
Correct Answer: D
Rationale: The correct answer is D because Medicare is a federal health insurance program that primarily covers individuals aged 65 and older, those with end-stage renal disease, and individuals with permanent disabilities. This answer aligns with the original intent and purpose of Medicare as established by the Social Security Act amendment.
Explanation:
1. Medicare was established to provide health insurance for specific groups, including individuals aged 65 and older, those with end-stage renal disease, and individuals with permanent disabilities.
2. The program was not designed to lead to hospital closings or decrease nursing care, as stated in choice A.
3. Choice B is incorrect because Medicare does not specifically target younger adults or children with catastrophic illnesses.
4. Choice C is incorrect because while Medicare may cover preventive care for certain populations, its primary focus is on providing insurance for specific age groups and individuals with specific health conditions.
A current trend is for students to be evaluated to determine whether they demonstrate competence in the actual client care environment or with a standardized patient. This process occurs in addition to or instead of traditional pencil-and-paper evaluations. This type of evaluation is referred to as:
- A. core practice competencies.
- B. continuing competence.
- C. distance learning.
- D. performance-based assessment.
Correct Answer: D
Rationale: The correct answer is D: performance-based assessment. This type of evaluation focuses on assessing students' ability to perform tasks and demonstrate competence in real-world scenarios, such as client care environments or with standardized patients. It is a more practical and hands-on approach compared to traditional pencil-and-paper evaluations. Core practice competencies (A) refer to essential skills and knowledge required for a specific profession. Continuing competence (B) involves ongoing professional development to maintain skills and knowledge. Distance learning (C) is a method of education that does not require physical presence in a traditional classroom setting. Performance-based assessment best aligns with the description provided in the question, making it the correct choice.
A client involved in a motor vehicle accident is blinded. The nurse helps the client obtain a guide dog so the client may continue grocery shopping and visiting friends and family. This enables the client to cope with the handicap and perform activities of daily living. Which nursing theory can be applied to this scenario?
- A. Watson's philosophy and science of caring and humanistic nursing
- B. Mishel's uncertainty in illness
- C. Orem's self-care deficit
- D. Rogers' science of unitary human beings
Correct Answer: A
Rationale: The correct answer is A: Watson's philosophy and science of caring and humanistic nursing. This theory emphasizes the importance of the nurse-client relationship, caring, and holistic care. In this scenario, obtaining a guide dog for the client reflects the nurse's caring actions to promote the client's independence and well-being. By helping the client cope with the handicap and continue daily activities, the nurse embodies the essence of caring and humanistic nursing.
Incorrect Choices:
B: Mishel's uncertainty in illness - This theory focuses on how individuals respond to uncertainty in illness situations, which does not directly apply to the scenario of obtaining a guide dog for a blinded client.
C: Orem's self-care deficit - This theory emphasizes the nurse's role in assisting clients with self-care activities when they are unable to do so independently. While related to the scenario, it does not capture the essence of caring and humanistic nursing demonstrated in the client's situation.
D: Rogers' science of unitary human beings - This
A Hispanic patient is visited by several family members and the nurse witnessed one visitor who pinches a piece of skin at the waist. The nurse asks the purpose and learns the "provider" is listening for a snap from the abdominal region, which is then repeated several times. The patient most likely suffers from:
- A. mal ojo.
- B. susto.
- C. bilis.
- D. empacho.
Correct Answer: D
Rationale: The correct answer is D: empacho. Empacho is a traditional Hispanic folk illness characterized by a blockage in the digestive system. In this scenario, the behavior of pinching the skin and listening for a snap in the abdominal region aligns with the common practice associated with empacho diagnosis. The family member is likely trying to detect an abnormal sound, indicating a blockage in the intestines. The other choices (A: mal ojo, B: susto, C: bilis) do not fit the description of the observed behavior and symptoms. Mal ojo refers to the evil eye, susto is a fright-related illness, and bilis pertains to an imbalance of bodily fluids, none of which involve the specific diagnostic behavior described in the scenario.
The Health Care Reform Act provides insurance for all U.S. citizens and legal residents presenting far-reaching ethical considerations related to diverse individual patient health care beliefs for those delivering nursing care. Nurses must consider their civil rights under the rights of conscience and how new health care agendas such as the Patient Protection and Affordable Care Act (PPACA) could affect their practice in situations that may conflict with their own belief system. Today's practicing nurse must:
- A. remember it is one's professional duty to render patient-centered care"even when it is in direct conflict with the nurse's own beliefs"or be held liable for withholding treatment.
- B. consider whether the right to act according to one's inner beliefs will continue to be permissible when federal health insurance becomes fully enacted.
- C. discuss with the patient and family different options in hopes they will accept the nurse's health care beliefs.
- D. suggest to the hospital administration that they not accept federal funding to prevent controversial health practices.
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct:
1. Professional duty: Nurses have a duty to provide patient-centered care regardless of personal beliefs.
2. Legal liability: Withholding treatment based on personal beliefs can lead to legal consequences.
3. Ethical considerations: Nurses must prioritize patient care over personal beliefs.
4. Rights of conscience: Nurses may have the right to refuse to participate in certain treatments, but they must still ensure patient care.
5. Patient-centered care: Nurses must respect patient autonomy and provide care based on the patient's wishes.
Summary of why the other choices are incorrect:
B. Irrelevant to the nurse's duty to provide patient-centered care.
C. Nurses should not impose their beliefs on patients but should respect and support their choices.
D. Suggesting the hospital not accept federal funding does not address the nurse's duty to provide patient-centered care.