Nursing Elites

1. What is the difference between mediation and binding arbitration based on the statement provided?

• A. Mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor
• B. Mediation uses a trained person to facilitate negotiations without making a final decision
• C. Binding arbitration is a formal process where an arbitrator's decision is final and must be adhered to by both parties
• D. Binding arbitration requires both labor and management to engage in discussions to find the least harmful resolution

Correct answer: C

Rationale: The key difference between mediation and binding arbitration lies in the finality of the decision. In binding arbitration, the arbitrator's decision is ultimate, and both parties are obligated to comply with it. This differs from mediation, where a neutral third party facilitates negotiations but does not make a final decision. Choice A is incorrect as mediation is not necessarily sanctioned by the NLRB; it can be conducted independently. Choice B is incorrect because mediation does not involve a final decision-maker but focuses on facilitating discussions. Choice D is incorrect as binding arbitration does not aim to find the least harmful resolution but rather a final and binding decision by the arbitrator.

2. How do accrediting agencies such as the Joint Commission ensure quality care?

• A. Imposing maximum staffing levels
• B. Stipulating nurse-patient ratios
• C. Confirming delivery of satisfactory care
• D. Requiring a specific staff mix

Correct answer: C

Rationale: Accrediting agencies such as the Joint Commission primarily focus on confirming the delivery of satisfactory care rather than imposing specific staffing levels, nurse-patient ratios, or staff mix. They do not dictate the exact staffing levels or ratios but rather evaluate if the care provided meets established quality standards. While adequate staffing levels and appropriate nurse-patient ratios are essential for quality care, accrediting agencies like the Joint Commission assess the outcomes and overall quality of care delivered by healthcare facilities.

3. How is motivation typically described?

• A. As a stagnant, unchanging force
• B. As a fluid, dynamic process that changes over time
• C. As a process that requires great force to change
• D. As a process that differs every day

Correct answer: B

Rationale: Motivation is commonly described as a fluid and dynamic process that evolves and changes over time. It is not stagnant but rather fluctuates based on various internal and external factors. Choice A is incorrect as motivation is not stagnant but dynamic. Choice C is incorrect as motivation does not necessarily require great force to change. Choice D is incorrect as motivation is not something that differs drastically every day, but rather changes gradually over time.

4. When the new graduate nurse shares a journal article about caring with peers, a more experienced nurse says, 'You’d be a lot better off studying pathophysiology instead of wasting time on caring.' How does the graduate interpret the experienced nurse’s comment?

• A. The experienced nurse is just mean and doesn’t like new graduates.
• B. The experienced nurse is most likely overworked and cranky.
• C. The experienced nurse was educated in the medical model.
• D. The experienced nurse is uncaring and dislikes new graduates.

Correct answer: C

Rationale: The experienced nurse's comment likely reflects their education in the medical model, which emphasizes technical skills over caring. This suggests a difference in educational background rather than personal animosity towards new graduates. Choice A is incorrect as it assumes personal dislike without considering educational differences. Choice B is incorrect as it attributes the behavior to being overworked and cranky, which is not supported by the information given. Choice D is incorrect as it makes a broad assumption about the experienced nurse's character without considering the context of their comment.

5. A healthcare professional walks into the nurse's station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions should the healthcare professional take first?

• A. remind the staff members that this is a breach of confidentiality
• B. discuss the issue with the unit manager
• C. request that an administrative restriction be placed on the client's medical access
• D. prepare a report for the facility ethics committee

Correct answer: A

Rationale: The correct action for the healthcare professional to take first is to remind the staff members that accessing the electronic medical record of a celebrity client from another unit is a breach of confidentiality. This immediate action addresses the ethical and legal issue at hand, emphasizing the importance of patient confidentiality and privacy. Discussing the issue with the unit manager, requesting administrative restrictions, or preparing a report for the facility ethics committee can be considered after addressing the initial breach and reminding staff members of their obligations.

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