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. When caring for a patient who just received a terminal diagnosis and is tearful and frightened, what is the best action to demonstrate caring?

• A. Call the patient's spiritual leader to talk to the patient.
• B. Call the patient's family and ask them to come sit with the patient.
• C. Cry with the patient while sympathizing with their situation.
• D. Sit with the patient and listen to their fears.

Correct answer: D

Rationale: In situations where a patient receives a terminal diagnosis and is emotionally distressed, it is essential to provide empathy and support. Sitting with the patient and actively listening to their fears allows the patient to express their emotions and concerns. This action demonstrates genuine care and compassion, showing the patient that their feelings are acknowledged and valued. It creates a therapeutic environment that fosters trust and emotional well-being, helping the patient cope with the distressing news. Calling the patient's spiritual leader (Choice A) may not address the immediate emotional needs of the patient. Calling the patient's family (Choice B) can be comforting but might not directly address the patient's fears. Crying with the patient (Choice C) can blur professional boundaries and may not be as beneficial as actively listening and providing support.

3. 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.

4. Who were the first public health nurses who provided care for the sick and the poor?

• A. The Presbyterian Church
• B. Salerno
• C. Jewish scholars
• D. Convent deaconesses

Correct answer: D

Rationale: The correct answer is D, Convent deaconesses. Deaconesses from local convents were the first public health nurses who provided care for the sick and the poor. They exemplified care guided by the Christian belief in compassion and helping others. The other choices (A, B, C) are incorrect because the Presbyterian Church, Salerno, and Jewish scholars were not specifically mentioned as the pioneers of public health nursing. The extract highlights the significant role of convent deaconesses in laying the foundation for modern public health nursing.

5. When the new graduate nurse shares a journal article about caring with peers, a more experienced nurse says, 'You’d be a lot better off studying pathophysiology instead of wasting time on caring.' How does the graduate interpret the experienced nurse’s comment?

• A. The experienced nurse is just mean and doesn’t like new graduates.
• B. The experienced nurse is most likely overworked and cranky.
• C. The experienced nurse was educated in the medical model.
• D. The experienced nurse is uncaring and dislikes new graduates.

Correct answer: C

Rationale: The experienced nurse's comment likely reflects their education in the medical model, which emphasizes technical skills over caring. This suggests a difference in educational background rather than personal animosity towards new graduates. Choice A is incorrect as it assumes personal dislike without considering educational differences. Choice B is incorrect as it attributes the behavior to being overworked and cranky, which is not supported by the information given. Choice D is incorrect as it makes a broad assumption about the experienced nurse's character without considering the context of their comment.

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