Nursing Elites

1. 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.

2. On what are most nursing paradigms based?

• A. The nurse's ability to perform procedures with skill
• B. Dr. Jean Watson's transpersonal caring theory
• C. Maslow's theory of hierarchy of needs
• D. Learning by studying nursing theories and clinical experiences

Correct answer: D

Rationale: Most nursing paradigms are founded on the understanding and application of nursing theories through studying them and gaining practical experiences in clinical settings. While the nurse's ability to perform procedures with skill is important, it is not the foundation of nursing paradigms. Dr. Jean Watson's transpersonal caring theory and Maslow's theory of hierarchy of needs are significant in nursing practice but do not serve as the basis for most nursing paradigms. Nursing paradigms are shaped by a combination of studying nursing theories and hands-on clinical experiences, which provide the foundational knowledge and practical skills needed for nursing practice.

3. 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.

4. What theme of critical thinking is demonstrated by the belief that continuous learning contributes to the ongoing process?

• A. Critical thinking is a productive and positive activity.
• B. Critical thinking is a process, not an outcome.
• C. Manifestations of critical thinking vary, depending on the context in which they occur.
• D. Critical thinking is triggered by both positive and negative events.

Correct answer: B

Rationale: The belief that continuous learning contributes to the ongoing process aligns with the theme that critical thinking is a process, not an outcome. This suggests that critical thinking involves a continuous, dynamic process of evaluating information, making connections, and adapting one's thinking over time, rather than being a fixed end result. Therefore, choice B is the correct answer. Choices A, C, and D do not directly address the continuous nature of critical thinking or its ongoing development, making them incorrect.

5. The patient tells the nurse that his insurance company requires him to pick a primary provider and asks what that means. The nurse explains that a primary provider means choosing what?

• A. A doctor
• B. A staff nurse
• C. One insurance provider
• D. A hospital

Correct answer: A

Rationale: A primary provider is typically a doctor, nurse practitioner, or physician's assistant who is responsible for overseeing and coordinating the patient's comprehensive healthcare needs. This healthcare professional serves as the main point of contact for the patient, managing preventive care, treatments, referrals to specialists, and overall health management. Choice B, a staff nurse, is incorrect as a primary provider is usually a more advanced healthcare professional managing comprehensive care. Choice C, one insurance provider, is incorrect as a primary provider refers to a healthcare professional, not an insurance company. Choice D, a hospital, is incorrect as the primary provider is an individual healthcare professional responsible for coordinating the patient's care, not a healthcare facility.

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