Nokea
The precise classification of clients according to the highest diagnosis-related group (DRG) has created a new role for nurses, known as a nurse.
- A. case management
- B. quality assurance
- C. utilization review
- D. cost-control
Correct Answer: A
Rationale: The correct answer is A: case management. Case management involves coordinating care for patients to ensure they receive appropriate services and resources. DRGs determine reimbursement based on patient diagnoses, making accurate classification crucial. Nurses in case management play a key role in ensuring patients are placed in the correct DRG category for optimal care and reimbursement.
Other choices are incorrect because:
B: Quality assurance focuses on monitoring and improving the quality of care, not specifically tied to DRG classification.
C: Utilization review involves assessing the appropriateness and necessity of healthcare services, not directly related to DRG classification.
D: Cost-control pertains to managing healthcare costs, but does not address the specific role of nurses in DRG classification and patient care coordination.
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The massage therapist uses kinesthesia, or thinking about how movement is expressed, to correct habits that cause poor posture and limited movement. This type of massage is called:
- A. Alexander technique.
- B. Feldenkrais method.
- C. healing touch.
- D. Reiki.
Correct Answer: B
Rationale: The correct answer is B: Feldenkrais method. This method focuses on improving movement patterns through kinesthetic awareness and re-education. It helps correct habits that lead to poor posture and limited movement by increasing awareness of how the body moves. The Alexander technique (A) mainly focuses on improving posture and reducing tension. Healing touch (C) involves energy-based healing practices, not specifically related to movement correction. Reiki (D) is a form of energy healing that aims to promote relaxation and stress reduction, not movement correction. Therefore, the best choice for the given scenario is the Feldenkrais method.
Health care professionals have been activated to respond to a disaster, and the registered nurse who is coordinating the effort realizes that: (select all that apply)
- A. in the event of a mass casualty incident, care is prioritized to those who have the greatest chance of surviving.
- B. communities should use their own resources first to attempt to stabilize and organize the response.
- C. state assistance occurs any time a disaster occurs, regardless of the community's resources.
- D. the emergency operating plan developed by one central agency rather than individual facilities should be put into operation.
Correct Answer: A
Rationale: The correct answer is A because in a mass casualty incident, triage principles dictate that care should be prioritized to those with the greatest chance of survival to maximize overall survival rates. This ensures that limited resources are used efficiently.
Choices B, C, and D are incorrect:
B: Using only community resources first may not be sufficient in a large-scale disaster and could delay the response, leading to unnecessary loss of life.
C: State assistance may not be automatically available in every disaster situation and is typically coordinated based on the severity and impact of the disaster.
D: Emergency operating plans should be tailored to individual facilities' needs and capabilities, as a one-size-fits-all approach may not be effective in all scenarios.
The staff on a nursing unit notes that patient satisfaction varies from month to month. They plot the degree of patient satisfaction each month for 1 year to determine when the periods of greatest dissatisfaction are occurring. The staff uses which type of graph?
- A. Time plot
- B. Pareto chart
- C. Flowchart
- D. Cause-and-effect diagram
Correct Answer: A
Rationale: The correct answer is A: Time plot. A time plot is the most appropriate graph for displaying data over time to identify trends and patterns. In this scenario, plotting patient satisfaction levels monthly over a year allows the staff to analyze fluctuations and identify periods of greatest dissatisfaction accurately.
Summary of other choices:
B: Pareto chart - Pareto charts are used to display the frequency of occurrences in a dataset in descending order. It is not suitable for analyzing trends over time.
C: Flowchart - Flowcharts are used to represent processes and workflows, not suitable for displaying time-series data.
D: Cause-and-effect diagram - Cause-and-effect diagrams are used to identify and analyze potential causes of a problem, not suitable for displaying time-series data.
A physician complains to administration that the nurse working last evening is unethical, based on observing the nurse educate the patient about a new medication ordered. The physician demanded the nurse be reprimanded and reminded that only physicians have the educational background to teach patients about new medications. Which comment and action by the administrator would be most effective in changing nurse-physician relationships in this instance?
- A. Inform the nurse, "You will be suspended for 3 days for going beyond your job description," and enforce the 3-day suspension because the physician did not write the order to "teach the patient about the new medication"
- B. Advise the physician that only nurses can teach patients about medications; the physician's role is to only prescribe. No action will be taken against the nurse.
- C. After investigating the situation, thank the physician while also providing information that patient education related to medication is within the scope of practice of registered nurses. Share the physician's concern and administrator's response with the nurse so both parties are aware of the resolution of the concerns.
- D. Contact the patient's family and ask, "Do you prefer that all teaching related to medications be performed by the physician rather than the nurse" to determine what action to take.
Correct Answer: C
Rationale: Step 1: The administrator acknowledges the physician's concern to maintain a professional relationship.
Step 2: The administrator educates the physician that patient education on medications falls within the nurse's scope of practice.
Step 3: The administrator addresses the nurse and physician to ensure both are informed of the resolution.
Step 4: This approach promotes mutual understanding and respect between nurse and physician.
Summary: Option C is the correct answer as it acknowledges the physician's concern, educates on scope of practice, and fosters communication between both parties. Options A, B, and D are incorrect as they either punish the nurse unjustly, fail to educate the physician, or involve unrelated parties in the decision-making process.
What effect did the movie One Flew Over the Cuckoo's Nest have on health care?
- A. Funding for mental health care increased, allowing the point of care to change from the community to standardized institutional care.
- B. The public and the nursing profession were made aware of the rights of vulnerable populations.
- C. Nurses were seen as advocates for individuals who cannot advocate for themselves.
- D. Funding for nursing traineeships was eliminated.
Correct Answer: B
Rationale: The correct answer is B because "One Flew Over the Cuckoo's Nest" raised awareness about the mistreatment of vulnerable populations in mental health institutions. It highlighted the need to uphold the rights of such individuals.
A is incorrect because the movie did not specifically lead to an increase in funding for mental health care or a shift to institutional care.
C is incorrect because while the movie portrayed nurses advocating for patients, it did not necessarily lead to a widespread perception of nurses as advocates for vulnerable populations.
D is incorrect because there is no evidence to suggest that funding for nursing traineeships was eliminated as a direct result of the movie.