Nursing Elites

1. In a unionized hospital, nurses receive compensatory pay for working holidays based on the hours worked with no extra compensation. Despite management refusing to consider changes to the compensatory pay system suggested by nurses during the annual employee satisfaction survey, a trend member listened to both parties and made non-legally binding recommendations. What is this type of settlement known as?

• A. Collective bargaining
• B. Mediation
• C. Grievance
• D. Binding arbitration

Correct answer: B

Rationale: Mediation involves a neutral third party who assists in resolving disputes by providing non-legally binding recommendations. In this scenario, the trend member acted as a mediator by listening to both nurses and management and offering suggestions without the authority to enforce them as a legally binding decision. Collective bargaining refers to negotiations between labor unions and employers to determine terms of employment. Grievance is a formal complaint by an employee against an employer. Binding arbitration involves a neutral third party making a final and legally binding decision to resolve a dispute.

2. While working in the clinical facility, the student nurse learns that a family member has been admitted to the same facility. What statement is true about the student's access to the family member's medical record?

• A. The student may access the family member's medical record as a nurse in the facility.
• B. The student nurse should not access the family member's record until obtaining instructor approval.
• C. The student may access the family member's medical record because of the family relationship.
• D. The student nurse should not view the record unless they are providing care for the family member.

Correct answer: D

Rationale: The student nurse should not view the family member's record unless they are directly involved in providing care to maintain confidentiality. Accessing the record without a legitimate reason breaches patient confidentiality and violates ethical principles. Choice A is incorrect because being a nurse in the facility does not automatically grant access to a family member's record. Choice B is incorrect as it does not address the primary concern of direct involvement in care. Choice C is incorrect as family relationship alone does not justify accessing the medical record.

3. The nurse is providing pre-operative teaching to the anxious patient, who doesn't seem to be learning. What need must the nurse help this patient meet before continuing to teach?

• A. Self-esteem
• B. Love and belonging
• C. Safety
• D. Self-actualization

Correct answer: C

Rationale: The correct answer is C: Safety. Before effective learning can occur, the patient's safety needs must be addressed. When patients feel safe and secure, they are better able to focus on receiving and processing information. Ensuring the patient's safety is a fundamental step in providing care and support, especially in a pre-operative setting where anxiety and concerns about the procedure may be high. Choices A, B, and D are incorrect because while self-esteem, love and belonging, and self-actualization are important needs, the immediate priority in this scenario is addressing the patient's safety concerns to create a conducive environment for learning.

4. When considering factors like high risk for falls, infection protocols, and special communication needs to determine the mix and number of staff needed on a telemetry unit, what is being utilized?

• A. diagnostic related groups
• B. clinical pathways
• C. case management
• D. Patient classification system

Correct answer: D

Rationale: In this scenario, the nurse is using a Patient Classification System, which helps in determining the appropriate staffing levels based on the acuity and care requirements of the patients in the telemetry unit. By considering factors like high risk for falls, infection protocols, and special communication needs, the nurse can allocate the right mix and number of staff to provide safe and effective care. The other choices are incorrect because diagnostic related groups are used for billing purposes, clinical pathways are standard care plans for specific diagnoses, and case management involves coordinating care and services for patients.

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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