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. What term is used to identify the care delivery model being used when a nurse makes patient care assignments as follows: RN1 has rooms 202-210, RN2 has rooms 211-221, RN3 has rooms 222-232. The unlicensed assistive personnel have half the rooms, with one assigned to 202-215 and the second to 216-232?

• A. Partnership
• B. Primary
• C. Modular
• D. Team

Correct answer: C

Rationale: The term used to identify the care delivery model being used in this scenario is 'Modular.' In modular nursing, a nursing unit is divided into modules, with each module staffed by a team assigned to specific rooms. This division allows for a more organized and efficient delivery of care, with clear assignments and responsibilities for each team. Choices A, B, and D are incorrect. Partnership typically refers to collaboration between healthcare providers; Primary is related to the patient's main healthcare provider; and Team is a general term that does not specifically describe the modular care delivery model outlined in the question.

3. A group of local volunteers has completed an emergency response course and is able to assist with the triage of injured citizens. They also participate in local health fairs to teach residents how to react during tornadoes. The responders are members of what organization?

• A. Metropolitan Medical Response System (MMRS)
• B. Medical Reserve Corps (MRC)
• C. National Disaster Medical System (NDMS)
• D. Commissioned Corps Readiness Force (CCRF)

Correct answer: B

Rationale: The Medical Reserve Corps (MRC) is the correct answer. This group consists of local volunteers who have completed emergency response training and are able to assist in the triage of injured citizens. Additionally, they participate in local health fairs to educate residents on tornado response procedures. The other choices are incorrect: MMRS (Metropolitan Medical Response System) focuses on coordinating resources for mass casualty incidents, NDMS (National Disaster Medical System) is a federally coordinated system for medical response during disasters, and CCRF (Commissioned Corps Readiness Force) is part of a specific governmental service branch.

4. According to Watson's theory, how should the nurse manager deal with a staff member who has a substance addiction and is arriving at work under the influence of the substance?

• A. Send the nurse home with instructions not to return until clear of the substance.
• B. Call the police and have the nurse arrested for working while impaired.
• C. Confront the nurse privately, order drug testing, and suggest a substance abuse program.
• D. Notify the board of nursing and fire the nurse immediately.

Correct answer: C

Rationale: According to Watson's theory, a caring approach is essential. Confronting the nurse privately, ordering drug testing, and suggesting a substance abuse program demonstrates empathy and supports the staff member in seeking help for their addiction. This approach aligns with the principles of human caring and compassion, focusing on the well-being and recovery of the individual rather than punitive measures. Choices A and D are too harsh and lack empathy, not considering the individual's well-being or offering support for rehabilitation. Choice B is inappropriate and punitive, not aligned with a caring and compassionate approach as advocated by Watson's theory.

5. 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.

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