Nokea
Which component of budgeting might normally be addressed in the annual performance evaluation for a nurse manager?
- A. Including in the labor budget costs for overtime and benefits
- B. Managing variances in nursing overtime costs and supply usage
- C. Accurately predicting revenues on the basis of unit-of-service
- D. Providing qualitative analysis for variances in the capital budget
Correct Answer: B
Rationale: Step 1: Managing variances in nursing overtime costs and supply usage is crucial for a nurse manager's performance evaluation as it demonstrates their ability to control expenses effectively.
Step 2: This component directly relates to the nurse manager's responsibility in budgeting and financial management.
Step 3: Analyzing and managing variances show the nurse manager's skill in monitoring and adjusting budgetary allocations to meet targets.
Step 4: Other choices are not directly related to the nurse manager's core responsibilities in budgeting or evaluating performance.
Step 5: Labor budget costs for overtime and benefits (Choice A) and predicting revenues (Choice C) are important but not as directly tied to performance evaluation as managing variances in costs.
Step 6: Providing qualitative analysis for variances in the capital budget (Choice D) is not typically a key aspect of a nurse manager's evaluation, as it focuses more on long-term investments rather than day-to-day operational budgeting.
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An interdisciplinary team is evaluating the hospital's care of patients admitted with a myocardial infarction (heart attack) compared to national standards. The team analyzes the hospital's clinical indicator, which would be: (select all that apply)
- A. aspirin order within 24 hours of discharge.
- B. patient teaching related to stopping smoking completed prior to discharge.
- C. beta blocker administered upon arrival.
- D. support of employer to modify stress in workplace.
Correct Answer: A
Rationale: The correct answer is A: aspirin order within 24 hours of discharge. This is a key clinical indicator for evaluating care of heart attack patients as aspirin is a standard treatment to prevent further cardiac events. It is crucial for patient safety and adherence to national guidelines.
Choice B is incorrect as patient teaching on smoking cessation, although important, is not a direct clinical indicator for evaluating care of heart attack patients.
Choice C is incorrect as beta blocker administration upon arrival is important for heart attack patients, but it is not specific to evaluating the hospital's care compared to national standards.
Choice D is incorrect as employer support for stress modification is not a clinical indicator relevant to evaluating care of heart attack patients.
During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy?
- A. An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway.
- B. A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power.
- C. A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call.
- D. A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.
Correct Answer: A
Rationale: The correct answer is A because denying the older person with Alzheimer's disease the right to ambulate violates their autonomy by restricting their freedom to make choices about their own body and movement. Autonomy is the ethical principle that respects an individual's right to make decisions about their own health and well-being. In this situation, the person should have the autonomy to decide whether or not they want to ambulate, even if they have advanced Alzheimer's disease.
Choice B is incorrect because the mentally competent adult has the right to refuse medical treatment based on their beliefs, which is an expression of autonomy.
Choice C is incorrect because the mentally competent visitor has the right to refuse examination, which is also an expression of autonomy.
Choice D is incorrect because the mentally competent adult has the right to refuse a local anesthetic, which is also an expression of autonomy.
A novice nurse is in the "rejection phase" of stress and wonders if she made the right decision when deciding nursing was her chosen career. Which strategy would help the novice nurse cope with transition into practice and reduce stress?
- A. When asked by the charge nurse to accept the new admission even though she had no discharges, the novice nurse stops and considers if this request is acceptable and safe, then accepts the assignment based on two patients having a low acuity level.
- B. Refusing to eat anywhere but the hospital cafeteria to ensure a balanced diet and time to socialize with other staff and visitors.
- C. Avoid wasting time by listening to coworkers' problems or ideas on how to staff the unit during the upcoming holiday since the novice nurse's time is valuable and better spent getting her own work completed.
- D. Make an effort to "win over" hostile or angry coworkers who find fault with the novice nurse's work performance.
Correct Answer: A
Rationale: The correct answer is A because it demonstrates a proactive and thoughtful approach to decision-making. By stopping to consider the request and assessing its safety implications before accepting it based on patient acuity levels, the novice nurse is prioritizing patient safety and her own capabilities. This strategy helps her cope with the transition into practice by promoting critical thinking and confidence in her decision-making skills.
Summary of why the other choices are incorrect:
B: Refusing to eat anywhere but the hospital cafeteria may lead to social isolation and restrict the novice nurse's ability to engage with others outside of work.
C: Ignoring coworkers' problems or staffing ideas can create a negative work environment and hinder teamwork, potentially increasing stress levels for the novice nurse.
D: Focusing on winning over hostile coworkers may detract from the novice nurse's professional growth and cause unnecessary stress from seeking validation from others.
A nurse entering the job market wants to be certain that the first position is rewarding and allows for growth as a registered nurse. According to the Hallmarks of the Professional Nursing Environment, the nurse should ask:
- A. about the philosophy related to clinical care to determine the role of RNs in deciding outcomes related quality outcomes.
- B. if professional development opportunities are supported through paid leave and tuition reimbursement.
- C. how compensation packages compare to others in the same area and nationally.
- D. what the projected need for RNs is in the next 5 years and current turnover rate.
Correct Answer: B
Rationale: The correct answer is B because professional development opportunities supported through paid leave and tuition reimbursement are crucial for a nurse's growth. This allows for continuous learning, skill enhancement, and career advancement. It indicates that the organization values its nurses and invests in their development. The other choices, A, C, and D, while important in their own right, do not directly address the nurse's growth and professional development. Choice A focuses on the philosophy of care, not personal growth. Choice C is mainly about compensation, not professional development. Choice D pertains to workforce planning, not individual career advancement.
The nurse caring for a patient states, "Your blood pressure is dangerously high. Are you taking antihypertensive medicine?" The patient states, "I can't afford my medicine. I have no insurance." The nurse states "I feel really sorry for that patient. I wish it wasn't against policy to give her money." The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that "She was so sick last evening when she came to the ED. I can't believe they don't provide insurance. I can't give her money but you all can help." This nurse:
- A. is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines.
- B. is at risk for HIPAA violations.
- C. has properly followed policy and protected the patient by not using her name.
- D. is demonstrating the logical fallacy of slippery slope.
Correct Answer: B
Rationale: The correct answer is B because the nurse is at risk for HIPAA violations by sharing patient information on social media. The Health Insurance Portability and Accountability Act (HIPAA) protects patients' privacy and prohibits healthcare providers from disclosing their health information without consent. In this scenario, the nurse shared specific details about the patient's health condition, visit to the ED, and financial situation, which could easily identify the patient. This violates the patient's right to privacy and confidentiality. Choices A, C, and D are incorrect because the focus should be on the HIPAA violation rather than empathy, policy following, or logical fallacies. The nurse should have found alternative ways to help the patient without compromising their privacy.