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Who establishes the "rules" for nursing practice?
- A. Individual state boards of nursing
- B. Employer, based on area of practice
- C. United States Department of Health and Human Services
- D. Local health officials
Correct Answer: A
Rationale: The correct answer is A: Individual state boards of nursing. State boards of nursing are responsible for regulating nursing practice within their respective states, including establishing rules and regulations to ensure safe and competent care. They set standards for licensure, education, and practice, as well as enforce disciplinary actions when necessary. State boards have the authority to govern nursing practice based on state laws and regulations. Employers, the US Department of Health and Human Services, and local health officials do not have the regulatory power to establish the rules for nursing practice at a state level.
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A nurse is concerned about safe staffing levels at a facility and observes that several units have no RN coverage but instead have RNs who float among several units. In determining whether this staffing concern should be reported to an outside agency, the nurse understands that, with whistle-blowing:
- A. reporting unsafe staffing levels to The Joint Commission provides protection from the employer.
- B. keeping copies of documented inappropriate staffing patterns in the nurse's personal file is illegal.
- C. when observing inappropriate staffing, the nurse should record her personal thoughts concerning the outcomes.
- D. one should seek guidance from a trusted individual who can provide an objective point of view.
Correct Answer: A
Rationale: The correct answer is A because reporting unsafe staffing levels to The Joint Commission is an appropriate course of action for addressing concerns about patient safety. The Joint Commission is an independent organization that accredits healthcare facilities and promotes high-quality care standards. Whistleblower protection laws safeguard employees who report violations of laws, regulations, or standards that threaten public health or safety. Reporting to The Joint Commission can lead to an investigation and potential improvement in staffing levels to ensure patient safety.
Incorrect answers:
B: Keeping copies of documented inappropriate staffing patterns in the nurse's personal file is not illegal, but it may not be the most effective way to address the issue.
C: Recording personal thoughts on outcomes is not as effective as taking action to report concerns to the appropriate regulatory body.
D: Seeking guidance is important, but in cases of unsafe staffing levels, it is crucial to report the issue to the appropriate regulatory agency for resolution.
A physician bills the insurance company for a computed tomography (CT) scan, laboratory tests, chest x-ray, and an extended visit and receives revenue for each procedure billed. This type of payment system is a payment system.
- A. prospective
- B. retrospective
- C. diagnosis-related group
- D. capitated
Correct Answer: D
Rationale: The correct answer is D: capitated. In a capitated payment system, the physician receives a fixed amount per patient regardless of the services provided. This incentivizes cost-effective care and promotes preventive measures. In this scenario, the physician is receiving revenue for each procedure billed, which is not characteristic of capitated payment.
A: Prospective payment is when a fixed amount is determined in advance for specific services rendered. This is not the case in the scenario provided.
B: Retrospective payment involves reimbursement after the services are provided, which is not reflected in the scenario given.
C: Diagnosis-related group (DRG) is a payment system used in hospitals based on the diagnosis and procedures performed, not applicable to individual physician billing as presented in the question.
A client involved in a motor vehicle accident is blinded. The nurse helps the client obtain a guide dog so the client may continue grocery shopping and visiting friends and family. This enables the client to cope with the handicap and perform activities of daily living. Which nursing theory can be applied to this scenario?
- A. Watson's philosophy and science of caring and humanistic nursing
- B. Mishel's uncertainty in illness
- C. Orem's self-care deficit
- D. Rogers' science of unitary human beings
Correct Answer: A
Rationale: The correct answer is A: Watson's philosophy and science of caring and humanistic nursing. This theory emphasizes the importance of the nurse-client relationship, caring, and holistic care. In this scenario, obtaining a guide dog for the client reflects the nurse's caring actions to promote the client's independence and well-being. By helping the client cope with the handicap and continue daily activities, the nurse embodies the essence of caring and humanistic nursing.
Incorrect Choices:
B: Mishel's uncertainty in illness - This theory focuses on how individuals respond to uncertainty in illness situations, which does not directly apply to the scenario of obtaining a guide dog for a blinded client.
C: Orem's self-care deficit - This theory emphasizes the nurse's role in assisting clients with self-care activities when they are unable to do so independently. While related to the scenario, it does not capture the essence of caring and humanistic nursing demonstrated in the client's situation.
D: Rogers' science of unitary human beings - This
The NCLEX examination is created and administered by the:
- A. American Association of Colleges of Nursing (AACN).
- B. American Nurses Association (ANA).
- C. National Council of State Boards of Nursing (NCSBN).
- D. National League for Nursing (NLN).
Correct Answer: C
Rationale: The correct answer is C: National Council of State Boards of Nursing (NCSBN). The NCLEX examination is developed and administered by the NCSBN, which is responsible for regulating nursing practice in the United States. They create the exam to ensure that nurses entering the profession meet minimum competency standards. The AACN (choice A) focuses on advancing nursing education, the ANA (choice B) is a professional organization representing nurses, and the NLN (choice D) is an organization that promotes excellence in nursing education. Therefore, the NCSBN is the only organization directly involved in the creation and administration of the NCLEX exam.
A group of nurses is presenting the importance of high-quality care during a system- wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm that:
- A. being insured has little effect on a person's longevity and the quality of care received.
- B. lobbyists for the drug companies are able to gain permission for the use of new drugs within 1 year of their discovery.
- C. although a greater number of lawsuits stem from medication errors, more people actually die from human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS).
- D. medication-related errors place a tremendous financial burden on the U.S. health care system.
Correct Answer: D
Rationale: The correct answer is D: medication-related errors place a tremendous financial burden on the U.S. health care system. This answer is correct because medication errors contribute significantly to healthcare costs due to increased hospitalizations, prolonged treatments, and legal expenses. The Quality Chasm report highlights the economic impact of medication errors on the healthcare system, emphasizing the need for improved medication safety practices.
Option A is incorrect because being insured does have a positive impact on a person's access to healthcare services and quality of care. Option B is incorrect as it does not relate to the Quality Chasm findings. Option C is incorrect as it focuses on the comparison of lawsuits and mortality rates related to medication errors and HIV/AIDS, which is not the primary focus of the Quality Chasm report.