The advanced practice nurse who is seeking information about requirements for practice in a specialized area should contact the:
- A. American Nurses Association (ANA).
- B. National League for Nursing (NLN).
- C. American Nurses Credentialing Center (ANCC).
- D. National Council of State Boards of Nursing (NCSBN).
Correct Answer: C
Rationale: The correct answer is C: American Nurses Credentialing Center (ANCC). ANCC is the primary organization responsible for certifying advanced practice nurses in specialized areas. They provide information on requirements for practice, certification exams, and continuing education. ANA (A) focuses on promoting the profession of nursing. NLN (B) focuses on nursing education. NCSBN (D) oversees the state boards of nursing and does not specifically provide information on requirements for practice in specialized areas.
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A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency?
- A. Safety
- B. Timely
- C. Equitable
- D. Patient-centered care
Correct Answer: A
Rationale: The correct answer is A: Safety. The team of nurses developing algorithms and checklists aims to ensure standardization of procedures, which directly relates to patient safety. Safety is a fundamental competency in healthcare, as it involves minimizing harm to patients. Standardization through checklists helps reduce errors and promote consistency in care delivery. Timely care (B) focuses on providing care promptly, equitable care (C) emphasizes fairness and eliminating disparities, and patient-centered care (D) prioritizes individual preferences and needs. While these competencies are important in healthcare, in this scenario, the team's primary focus on standardization aligns with the safety competency.
An elderly person, age 80, is finding it difficult to live alone and the family is considering long-term care. The elderly person is reasonably healthy, with only normal aging declines, and maintains a healthy appetite. All medications are administered orally and require only minimal assistance. She is financially secure with an income based on retirement from both the military and factory from her deceased husband and herself. The family contacts long- term care and is told that, based on this patient's information:
- A. Medicare will cover the cost of stay since skilled services are required.
- B. Medicaid is only for families with dependent children.
- C. Medicare will pay for home health services should these additional services meet the needs of the individual.
- D. Medicare will pay regardless of household income or financial status for nursing home care.
Correct Answer: C
Rationale: Rationale for Correct Answer (C): Medicare will pay for home health services should these additional services meet the needs of the individual.
1. Medicare covers home health services for individuals who meet specific criteria, which may include being homebound, needing skilled nursing care, and having a care plan established by a healthcare provider.
2. In this scenario, the elderly person is reasonably healthy and only requires minimal assistance with oral medications, indicating that she may benefit from home health services rather than long-term care.
3. Since the elderly person is financially secure, it is likely that she does not meet the eligibility criteria for Medicaid, which is a need-based program for individuals with limited income and resources.
4. Medicare does not cover long-term care in a nursing home unless specific criteria are met, such as requiring skilled services on a short-term basis. In this case, the elderly person's need for assistance with oral medications does not necessarily qualify as a skilled service for nursing home care.
Summary of Incorrect Choices:
A
A family requests that no additional heroic measures be instituted for their terminally ill mother who has advance directives in place. The nurse respects this decision in keeping with the principle of:
- A. accountability.
- B. autonomy.
- C. nonmaleficence.
- D. veracity.
Correct Answer: B
Rationale: The correct answer is B: autonomy. Autonomy refers to respecting the right of individuals to make their own decisions about their healthcare. In this scenario, the family's request to honor the terminally ill mother's advance directives aligns with the principle of autonomy as it acknowledges her right to make decisions about her own care. Accountability (A) pertains to taking responsibility for one's actions, nonmaleficence (C) involves avoiding harm, and veracity (D) refers to truthfulness. While these principles are important in healthcare, in this specific case, autonomy takes precedence as it respects the patient's wishes.
An RN recently relocated to another region of the country and immediately assumed the role of charge nurse. When determining the appropriate person to whom to delegate, the RN knows that:
- A. the role of the LPN/LVN is the same from state to state.
- B. the LPN/LVN can be taught to perform all the duties of an RN if approved by the employer and if additional on-the-job training is provided.
- C. he or she must review the state's nurse practice act for LPN/LVNs, because each state defines the role and scope of practice of the LPN/LVN.
- D. The Joint Commission has certified and established roles for the LPN/LVN.
Correct Answer: C
Rationale: The correct answer is C. When delegating tasks to an LPN/LVN, the RN must review the state's nurse practice act because each state defines the role and scope of practice of the LPN/LVN. This is crucial as the LPN/LVN scope of practice can vary significantly from state to state. By reviewing the nurse practice act, the RN ensures that the tasks being delegated fall within the legal scope of practice for the LPN/LVN in that specific state, promoting safe and effective patient care.
Choice A is incorrect because the role of the LPN/LVN can differ between states.
Choice B is incorrect because LPN/LVNs cannot perform all duties of an RN, and additional training does not change their scope of practice.
Choice D is incorrect because the Joint Commission does not establish roles for LPN/LVNs; it focuses on accreditation standards for healthcare organizations.
The disaster medical assistance team works quickly to contain contaminants from a chemical plant explosion. Afterward, personnel undergo a special process to remove harmful chemicals from equipment and supplies. This removal process is known as:
- A. containment.
- B. decontamination.
- C. triage.
- D. scene assessment.
Correct Answer: B
Rationale: The correct answer is B: decontamination. Decontamination is the process of removing harmful chemicals from equipment and supplies to prevent further exposure and contamination. In this scenario, the disaster medical assistance team is working to contain contaminants first and then proceed with decontamination to ensure the safety of personnel. Containment (choice A) refers to preventing the spread of contaminants, not removing them. Triage (choice C) is the process of prioritizing patients based on the severity of their injuries, not removing chemicals. Scene assessment (choice D) involves evaluating the situation to determine the extent of the disaster, not the removal of harmful chemicals.
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