Contemporary Ethical Issues in Nursing

Contemporary Ethical Issues in Nursing Related

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The nurse manager meets with upper management to share strategic goals agreed upon by her staff for their individual nursing unit as the first step to begin budget negotiations. One strategic goal is that staff will have access to technology that will allow them to incorporate point-of-care devices for all RNs. The second goal is to improve RNs' ability to recognize critical indicators that a patient's health status is deteriorating through advanced health assessment skills. During the meeting the manager discusses the strategy options and selecting the one that works for the unit. Which type of budget development is used?

  • A. Iterative
  • B. Top-down
  • C. Participatory
  • D. Zero-based
Correct Answer: C

Rationale: The correct answer is C: Participatory. In participatory budget development, input is gathered from various levels within the organization, such as staff and managers. In this scenario, the nurse manager met with her staff to establish strategic goals before budget negotiations, indicating a participatory approach. This allows for staff buy-in and ownership of the goals.

A: Iterative budget development involves refining a budget through multiple rounds of review, which is not explicitly mentioned in the scenario.
B: Top-down budget development is characterized by decisions made by upper management without input from lower levels, contradicting the scenario where staff provided input.
D: Zero-based budgeting starts from scratch without considering previous budgets, which is not evident in the scenario where goals were established based on staff input.

In summary, the participatory budget development is the appropriate choice in this scenario as it aligns with the collaborative approach taken by the nurse manager and her staff in setting strategic goals before budget negotiations.

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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.

Which functions can be delegated only to another RN with appropriate experience and training? (select all that apply)

  • A. Assessment of skin integrity on third day of hospitalization
  • B. Evaluation of patient teaching related to turn, cough, and deep breathing exercises
  • C. Nursing judgment related to withholding medication based on vital signs
  • D. RNs do not delegate to other RNs, they delegate only to licensed practical nurses or unlicensed assistive personnel
Correct Answer: C

Rationale: The correct answer is C because nursing judgment related to withholding medication based on vital signs requires critical thinking, clinical knowledge, and experience. This decision-making process involves assessing the patient's condition, interpreting vital signs, and determining if medication should be given or withheld to ensure patient safety. This function cannot be delegated to someone without the appropriate training and expertise.

A: Assessment of skin integrity on the third day of hospitalization can be delegated to other healthcare team members such as LPNs or nursing assistants, as long as they have been trained and deemed competent.
B: Evaluation of patient teaching related to turn, cough, and deep breathing exercises can be delegated to other healthcare team members, as long as they have the appropriate training and supervision.
D: The statement that RNs do not delegate to other RNs is incorrect. RNs can delegate certain tasks to other RNs based on their scope of practice and level of experience. It is not limited to LPNs or unlicensed assistive personnel.

The nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers is called a:

  • A. nurse manager.
  • B. case manager.
  • C. coordinator of patient-centered care delivery.
  • D. team leader in team nursing care delivery.
Correct Answer: B

Rationale: The correct answer is B: case manager. A case manager is responsible for coordinating care for a patient from admission to discharge, collaborating with various healthcare providers. This role involves managing the patient's overall care plan, ensuring continuity and efficiency. The other choices are incorrect because:
A: Nurse manager focuses on managing nursing staff and unit operations, not individual patient care.
C: Coordinator of patient-centered care delivery may oversee care coordination but does not necessarily follow the patient throughout the entire care journey.
D: Team leader in team nursing care delivery is focused on leading a specific nursing team, not managing the patient's entire care process.

Which statement is true regarding health care for minorities?

  • A. Federal legislation that provides free health insurance for minorities has resulted in fewer minorities than members of the general population who lack health insurance.
  • B. Higher costs of health care coupled with lower wages for minorities have prevented most minorities from seeking health care.
  • C. Because many Mexican Americans are highly skilled workers with comparable wages, they have the lowest uninsured rate.
  • D. Asians, because of their quiet demeanor and unwillingness to challenge the health care system, have the highest rate of uninsured people.
Correct Answer: A

Rationale: Step-by-step rationale for why answer A is correct:
1. Federal legislation such as the Affordable Care Act has expanded Medicaid coverage and provided subsidies for health insurance.
2. This legislation has helped reduce the number of minorities lacking health insurance.
3. Consequently, fewer minorities than members of the general population now lack health insurance.
4. Therefore, the statement that federal legislation has resulted in fewer minorities lacking health insurance is true.

Summary of why other choices are incorrect:
B. This choice incorrectly attributes the lack of seeking health care by minorities solely to higher costs and lower wages, overlooking the impact of legislation.
C. This choice makes a sweeping generalization about Mexican Americans without considering the broader context of health care access for minorities.
D. This choice relies on stereotypes about Asians and does not take into account the complexities of the health care system and insurance coverage.

Positive time management skills include:

  • A. maintaining an open-door policy.
  • B. retaining all paperwork.
  • C. returning all telephone calls immediately.
  • D. scheduling daily activities.
Correct Answer: D

Rationale: The correct answer is D: scheduling daily activities. This is because positive time management skills involve planning and organizing tasks to effectively utilize time. By scheduling daily activities, individuals can prioritize tasks, set goals, and allocate time efficiently. This helps in achieving productivity and reducing stress.

Choice A (maintaining an open-door policy) is incorrect as it pertains to communication style, not time management. Choice B (retaining all paperwork) is not directly related to time management but rather to organization. Choice C (returning all telephone calls immediately) is also not a direct indicator of effective time management as it focuses on communication responsiveness rather than overall time utilization.

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