Nursing Elites

1. If a nurse accepts the role of charge nurse on the evening shift, what effect will unionization have on the nurse's new position?

• A. The nurse can file a grievance that will be arbitrated automatically by the Union
• B. Charge nurse is part of the management team, so Union participation would be a conflict of interest
• C. The nurse is not eligible for collective bargaining activities dealing with unfair labor practices
• D. The nurse can be represented by the union because charge nurses are not considered part of the management team

Correct answer: B

Rationale: Choosing answer B is correct because charge nurses are typically considered part of the management team. As part of the management team, the charge nurse has decision-making responsibilities that align with the interests of the organization. Therefore, participating in a union would create a conflict of interest. Options A, C, and D are incorrect. Option A is incorrect because union arbitration is not typically applicable to management positions. Option C is incorrect because charge nurses, as part of the management team, would not be eligible for collective bargaining activities like frontline staff. Option D is incorrect because charge nurses, due to their managerial responsibilities, are generally not represented by unions for collective bargaining purposes.

2. The increasing use of licensed practical nurses (LPNs) in management positions, especially in long-term care facilities, is an example of what?

• A. Assertive management
• B. A shifting paradigm
• C. Critical thinking
• D. Smarter LPN graduates

Correct answer: B

Rationale: The correct answer is B: A shifting paradigm. The increasing use of LPNs in management positions, particularly in long-term care facilities, represents a changing paradigm in healthcare management. This shift indicates a move towards assigning leadership responsibilities to LPNs, signaling a departure from traditional industry roles. Choices A, C, and D are incorrect because the situation described does not primarily demonstrate assertive management, critical thinking, or the intelligence of LPN graduates. The focus is on the evolving role of LPNs in management, suggesting a broader change in healthcare practices.

3. How does the high degree of professionalism among nurses impact their willingness to engage in organized strikes?

• A. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession
• B. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization
• C. Nurses who strike can be legally punished for abandonment and negligence considered to be professional misconduct
• D. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client's safety initiatives

Correct answer: A

Rationale: The correct answer is A. The high level of professionalism among nurses, as recognized in Gallup polls, often leads them to perceive organized strikes as conflicting with their duty to care for patients and uphold their professional standards. This conflict of interest can cause nurses to be hesitant or reluctant to participate in strikes. Choice B is incorrect because nurses' decision to engage in strikes is more influenced by professional values and patient care rather than evidence-based studies on management and labor views. Choice C is incorrect because while legal consequences may be a concern, the primary factor influencing nurses' decision on strikes is their professional commitment to patient care. Choice D is incorrect as nurses' focus during strikes is more on advocating for patient safety rather than emphasizing safety initiatives.

4. A client with a terminal illness is concerned about performing self-care after discharge. Which of the following statements should the nurse make?

• A. A social worker will address your concerns after discharge.
• B. You should plan to go to a skilled nursing facility after discharge.
• C. Your case manager will coordinate the resources you will need.
• D. You will need hospice care until you feel stronger.

Correct answer: C

Rationale: In this scenario, the most appropriate statement for the nurse to make is that the case manager will coordinate the resources needed for self-care after discharge. Case managers are responsible for organizing and ensuring the provision of necessary resources and services to support the patient's care plan, making this the best option among the choices provided. Social workers typically address psychosocial concerns, skilled nursing facilities are for more intensive care needs, and hospice care is usually for end-of-life care, making them less suitable responses in this context.

5. What is the primary focus of the Patient Protection and Affordable Care Act?

• A. Reducing the cost of healthcare
• B. Providing healthcare to undocumented immigrants
• C. Ensuring access to healthcare for all Americans
• D. Eliminating the need for health insurance

Correct answer: C

Rationale: The correct answer is C: Ensuring access to healthcare for all Americans. The primary focus of the Patient Protection and Affordable Care Act is to expand coverage, improve quality of care, and make healthcare more affordable and accessible to a greater number of people in the United States. Choice A is incorrect because while the act aims to make healthcare more affordable, its primary focus is on access. Choice B is incorrect as the act is not specifically designed to provide healthcare to undocumented immigrants. Choice D is incorrect as the act does not aim to eliminate the need for health insurance but rather improve the availability and affordability of insurance coverage.

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