Nokea
The key to organizational success for health care facilities is:
- A. hiring younger, more energetic nurses.
- B. offering incentives such as sign-on bonuses.
- C. hiring highly qualified advanced practice nurses.
- D. retaining professional nurses.
Correct Answer: D
Rationale: The correct answer is D: retaining professional nurses. Retaining professional nurses is crucial for organizational success in healthcare facilities as it ensures continuity of care, promotes staff morale, reduces turnover costs, and maintains high-quality patient outcomes. By retaining experienced and skilled nurses, organizations can benefit from their expertise, knowledge, and commitment to providing excellent patient care.
A: Hiring younger, more energetic nurses may bring new perspectives and energy but does not guarantee the same level of experience and expertise as professional nurses.
B: Offering incentives like sign-on bonuses may attract new hires, but it does not address the underlying issues that lead to nurse turnover.
C: Hiring highly qualified advanced practice nurses is beneficial, but it does not address the importance of retaining all professional nurses within the organization.
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A nurse caring for a patient with anemia and heart failure prepares to hang a unit of packed red blood cells and realizes her break is in 5 minutes. She decides it is not necessary to have another nurse check the blood against the patient's information since the patient's blood type is O+ which she incorrectly remembered to be the universal donor. She hangs the blood, noting the patient is "reading and vital signs normal." She leaves the floor for her break and does not report leaving or ask anyone to perform required vital signs. Upon returning she meets a family friend who is visiting and time "just flies." She returns to the patient's room after admitting a new patient. The patient is hypotensive and color is cyanotic and anxious. She reports the findings to the charge nurse, who then contacts the physician. A blood reaction occurrence is noted. The nurse providing care is charged:
- A. with comparative negligence.
- B. with a preventable adverse event.
- C. with criminal negligence.
- D. under the doctrine of res ipsa loquitur.
Correct Answer: C
Rationale: The correct answer is C: with criminal negligence. The nurse displayed a reckless disregard for the patient's safety by not verifying the blood type, leaving for an extended break without ensuring proper monitoring, and failing to report her absence. These actions were highly irresponsible and demonstrated a severe lack of care and attention to the patient's well-being. Criminal negligence involves a conscious disregard for the consequences of one's actions, which in this case resulted in a serious adverse event for the patient. Choices A and B do not fully capture the gravity of the nurse's actions, as they imply a lesser degree of fault. Choice D, under the doctrine of res ipsa loquitur, would be inappropriate in this scenario as the nurse's actions directly contributed to the adverse outcome.
A client arrives in active labor and exhibits toxemia with irregular fetal heart tones. The client is an immigrant and is uninsured. Which act would prevent the client from being transferred to another facility?
- A. Emergency Medical Treatment and Active Labor Law
- B. Health Insurance Portability and Accountability Act
- C. Patient Self-Determination Act
- D. The Patient Safety and Quality Improvement Act
Correct Answer: A
Rationale: The correct answer is A: Emergency Medical Treatment and Active Labor Law (EMTALA). This act prohibits hospitals from transferring patients in active labor or with an emergency condition based on insurance status or ability to pay. It ensures that all individuals, regardless of insurance or immigration status, receive necessary emergency medical treatment. The other choices are incorrect because:
B: Health Insurance Portability and Accountability Act (HIPAA) protects patient privacy and does not address transfer of patients in active labor.
C: Patient Self-Determination Act focuses on patient autonomy in making healthcare decisions, not on preventing transfer based on insurance status.
D: The Patient Safety and Quality Improvement Act promotes patient safety and quality improvement but does not specifically address transfer of patients in active labor.
What uniquely twenty-first century issue challenges today's professional nurse. (select all that apply)
- A. Caring for an aging population
- B. Increased patient acuity
- C. Access to health care services
- D. Expanding technology
Correct Answer: A
Rationale: The correct answer is A: Caring for an aging population. This is a uniquely twenty-first-century issue as advancements in healthcare have increased life expectancy, leading to a larger elderly population with complex healthcare needs. Nurses must adapt their skills and knowledge to provide specialized care for this demographic.
B: Increased patient acuity is a common challenge but not unique to the twenty-first century. Nurses have always dealt with varying levels of patient acuity.
C: Access to health care services is an ongoing issue that has been prevalent for many years, not specifically unique to the twenty-first century.
D: Expanding technology is also a significant challenge for nurses in the modern era, but it is not uniquely a twenty-first-century issue as technology has been advancing for decades.
In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees' health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin's planned change?
- A. Unfreeze
- B. Move
- C. Refreeze
- D. Acceptance
Correct Answer: A
Rationale: The correct answer is A: Unfreeze. In this scenario, the handout is aimed at creating dissatisfaction with the current state of health insurance among employees, which aligns with the unfreezing stage of Lewin's planned change model. Unfreezing involves creating awareness of the need for change by highlighting deficiencies in the current state. The handout is triggering employees to reevaluate their current health insurance and consider alternative options. Choices B, C, and D are incorrect because they do not capture the initial stage of creating dissatisfaction and readiness for change, as seen in the unfreezing phase.
A nurse wants to apply open communication to obtain a thorough history and to determine cognitive function. Which question represents the use of open communication?
- A. Is today Wednesday?
- B. Do you know what day it is?
- C. Tell me what day of the week today is.
- D. Do you know what the first day of the week is?
Correct Answer: C
Rationale: The correct answer is C because it encourages the patient to provide detailed information and express themselves freely. By asking the patient to "Tell me what day of the week today is," the nurse is prompting an open-ended response, allowing the patient to share their understanding. Choice A is closed-ended, requiring a simple yes/no answer. Choice B is slightly better as it prompts for information, but it is still closed-ended. Choice D is irrelevant to the question of determining cognitive function and history. In summary, C promotes open communication by encouraging the patient to elaborate, while the other choices limit the patient's response.