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. How can a student best prepare for a clinical experience?

• A. Practice and review procedures for performing skills
• B. Review class notes from the past week
• C. Familiarize oneself with the clinical facility
• D. Arrive at the clinical site 1 hour early

Correct answer: A

Rationale: Practicing and reviewing procedures for performing skills is crucial for a student preparing for a clinical experience. This preparation allows the student to build competence and confidence in executing required tasks. Reviewing class notes may be helpful for theoretical knowledge but may not adequately prepare the student for practical skills needed in a clinical setting. Familiarizing oneself with the clinical facility is beneficial but does not directly address skill readiness. Arriving early is important but does not substitute for the essential preparation of practicing and reviewing procedures for performing skills.

3. Who is credited with creating a written record of health care practices and dispelling the mythical aspect of health care?

• A. Hammurabi
• B. Florence Nightingale
• C. Hippocrates
• D. Apollo

Correct answer: C

Rationale: Hippocrates is credited with creating the first medical textbook, where he documented contemporary health care practices and separated them from the mythical belief that Apollo was responsible for health. Hippocrates' work laid the foundation for evidence-based medicine and emphasized the importance of observation and clinical experience in healthcare practices. Choice A, Hammurabi, is known for his code of laws rather than medical advancements. Florence Nightingale is recognized for her contributions to nursing and healthcare reform, not for creating a written record of health care practices. Apollo, a Greek god associated with healing, is part of the mythical aspect of health care that Hippocrates aimed to dispel.

4. A patient is admitted with pneumonia. My case manager refers to a plan of care that specifically identifies dates when supplemental oxygen should be discontinued, positive pressure ventilation with bronchodilators should be changed to self-administer inhalers, and antibiotics should be changed from intravenous to oral treatment, based on assessment findings. This plan of care is referred to by what term?

• A. patient classification system
• B. patient-centered plan of care
• C. diagnosis-related group
• D. clinical pathway

Correct answer: D

Rationale: A clinical pathway is a structured, evidence-based plan that outlines the expected course of treatment and interventions for a specific diagnosis or procedure, in this case, pneumonia. It includes guidelines on the timing of interventions and transitions in care based on assessment findings, promoting standardized care and improved outcomes for patients. The other choices are incorrect: A) patient classification system categorizes patients based on similar characteristics; B) patient-centered plan of care focuses on individual patient needs and preferences; C) diagnosis-related group is a classification system used for billing purposes.

5. The healthcare provider responds to an alarm on a pulse oximeter and sees that the patient's oxygen saturation is reading 38%. The provider observes the patient, noting a respiratory rate of 12 breaths per minute, pink mucous membranes, and easy regular respirations. The healthcare provider concludes that the pulse oximeter is not reading accurately. Whose theory of healthcare is this provider demonstrating?

• A. Annie Goodrich
• B. Lillian D. Wald
• C. Florence Nightingale
• D. Linda Richards

Correct answer: C

Rationale: Florence Nightingale emphasized the importance of assessing the patient's overall condition and not solely relying on technological readings. In this scenario, the healthcare provider's observation of the patient's respiratory rate, mucous membranes, and breathing pattern aligns with Nightingale's holistic approach to patient care. Annie Goodrich is known for her contributions to nursing education; Lillian D. Wald is associated with public health nursing and social reform; Linda Richards is recognized as America's first trained nurse. However, in this context, the emphasis is on the holistic patient assessment, which is a key principle of Florence Nightingale's theory.

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