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When reviewing the literature on the effects of Medicaid on health care for the poor, the nurse researcher found that the poor:
- A. have less access than even the uninsured.
- B. receive many unnecessary treatments.
- C. lack consistent providers.
- D. abuse preventive services.
Correct Answer: C
Rationale: The correct answer is C because lacking consistent providers is a common issue among the poor utilizing Medicaid. This impacts continuity of care, leading to fragmented health services and poor health outcomes. Choice A is incorrect as Medicaid does provide some level of access to healthcare. Choice B is incorrect as unnecessary treatments are not a common issue among the poor on Medicaid. Choice D is incorrect as preventive services are underutilized rather than abused by the poor on Medicaid.
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A priority action for the nurse who works with culturally diverse clients is completion of a:
- A. sign language course.
- B. cultural self-assessment.
- C. cultural client assessment.
- D. continuing education course on how to speak Spanish.
Correct Answer: B
Rationale: The correct answer is B: cultural self-assessment. This is important as it helps the nurse understand their own beliefs, values, and biases, which can impact how they interact with culturally diverse clients. By being self-aware, the nurse can better recognize and address any potential cultural misunderstandings or conflicts.
A: Taking a sign language course is not the priority as not all culturally diverse clients are deaf or use sign language.
C: While cultural client assessment is important, it is secondary to the nurse understanding their own cultural biases first.
D: Taking a course on how to speak Spanish is helpful but may not address the broader cultural competence needed to work with diverse clients.
In differentiating between interprofessional and multidisciplinary:
- A. multidisciplinary refers to the care of many diverse patients by one discipline.
- B. interprofessional involves members of many disciplines working together to provide patient care to a distinct population.
- C. interprofessional refers to members of the same discipline working together to provide patient care to a distinct population.
- D. interprofessional is the use of multiple interventions by nurses with varying levels of education.
Correct Answer: B
Rationale: The correct answer is B because interprofessional involves members of different disciplines collaborating to provide patient care, promoting a holistic approach. This fosters shared decision-making and communication among healthcare professionals, leading to improved patient outcomes.
A is incorrect because multidisciplinary involves multiple disciplines treating a single patient, not many diverse patients.
C is incorrect because interprofessional involves different disciplines, not members of the same discipline working together.
D is incorrect because interprofessional is about collaboration between different disciplines, not the use of multiple interventions by nurses specifically.
A physician shares with the patient's family that, while a central line was being inserted, the patient's lungs were inadvertently punctured, which required oxygen administration. The physician also explains that a chest x-ray indicated the lung remained intact and no additional treatment was required. The physician's role in this instance is based on the legal principle of:
- A. comparative negligence.
- B. gross negligence.
- C. disclosure.
- D. the Emergency Medical Treatment and Active Labor Act (EMTALA).
Correct Answer: C
Rationale: The correct answer is C: disclosure. In this scenario, the physician shared information about the accidental lung puncture with the patient's family, demonstrating transparency and honesty. This aligns with the legal principle of disclosure, which emphasizes the importance of informing patients and their families about relevant medical information. The physician's actions foster trust and open communication, ensuring that the patient and family are informed about the situation.
Choice A: comparative negligence, is incorrect because it involves assessing the degree of negligence by both parties involved, which is not applicable in this context.
Choice B: gross negligence, is incorrect because the physician's actions do not demonstrate recklessness or a complete disregard for the patient's safety.
Choice D: the Emergency Medical Treatment and Active Labor Act (EMTALA), is incorrect because this law primarily addresses the provision of emergency medical care and ensuring access to necessary services, not the disclosure of medical errors.
A nurse manager wants his nursing unit to be a place where all nurses want to work, where patient satisfaction is high, and care is innovative and interdisciplinary. Staff are encouraged to chair taskforces to improve quality of care and he counsels staff in areas of measuring patient outcomes. Other managers want to mimic this manager's approach to improve their own units. This nurse is which type of leader?
- A. Transformational
- B. Transactional
- C. Laissez-faire
- D. Authoritative
Correct Answer: A
Rationale: The correct answer is A: Transformational. This nurse manager is focused on creating a positive work environment, encouraging innovation, empowering staff, and promoting interdisciplinary collaboration. Transformational leaders inspire and motivate followers to achieve high levels of performance by emphasizing shared vision, personal growth, and values. This nurse manager's approach aligns with the characteristics of a transformational leader.
Incorrect Choices:
B: Transactional leaders focus on rewards, punishments, and exchanges with followers based on performance. This nurse manager's approach goes beyond transactional interactions.
C: Laissez-faire leaders are hands-off and provide little guidance or direction. This nurse manager is actively involved in guiding and supporting staff.
D: Authoritative leaders make decisions independently and expect followers to follow orders. This nurse manager encourages staff involvement and input in decision-making processes.
A client is admitted with chest pain. A series of diagnostic tests are ordered, and the client undergoes coronary artery bypass grafting. The cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (ICU) stay by 3 days because of respiratory problems. The case manager realizes that under the terms of the diagnosis-related group (DRG) payment system for this diagnosis:
- A. the cost of caring for this client was $5000 greater than the DRG reimbursement fee, and the hospital will be allowed to collect the additional fees from the insurance company.
- B. although the cost of care for this client was greater than the DRG reimbursement amount, the hospital will be reimbursed only at the set fee.
- C. the client will be sued to pay back the insurance company for the extra fees incurred because smoking is a modifiable health risk for heart disease.
- D. the physician who admitted the client will receive a reduced payment to cover the loss incurred by the hospital.
Correct Answer: B
Rationale: The correct answer is B. The DRG payment system is a fixed reimbursement amount for a specific diagnosis or procedure. In this case, the cost of care exceeded the DRG reimbursement amount due to the extended ICU stay caused by the client's smoking history. The hospital will only be reimbursed at the set fee specified by the DRG, regardless of the actual cost incurred.
Choice A is incorrect because the hospital cannot collect additional fees from the insurance company beyond the DRG reimbursement amount. Choice C is incorrect as the client is not typically held responsible for the additional costs incurred. Choice D is incorrect because physician payment is not directly impacted by the hospital's financial losses. The DRG system focuses on fixed reimbursements based on diagnoses, not individual physician payments.