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. Medicaid, which is financed by what part of the government, is jointly funded by which two entities?

• A. State
• B. Federal
• C. County
• D. State and federal

Correct answer: D

Rationale: Medicaid is a healthcare program jointly funded by the state and federal governments. States have flexibility in administering Medicaid while adhering to federal guidelines, and both entities contribute funding to support the program. Choice A (State) is incorrect as Medicaid is not solely funded by the state government. Choice B (Federal) is not the only funding source for Medicaid. Choice C (County) is not a primary entity involved in financing Medicaid, making it incorrect. The correct answer is D, as Medicaid receives funding from both the state and federal governments.

3. When a nurse reads a peer-reviewed nursing journal article recommending a change in caring for a patient with an indwelling urinary catheter, which action demonstrates critical thinking?

• A. Implementing the article's recommendations in caring for a patient with an indwelling urinary catheter
• B. Presenting the journal article to the nurse manager and proposing a revision of the procedure
• C. Seeking additional peer-reviewed articles that corroborate the author's recommendation
• D. Disregarding the article and adhering to the facility's existing procedure

Correct answer: C

Rationale: Critical thinking involves evaluating information from various sources. In this scenario, the nurse displays critical thinking by seeking additional peer-reviewed articles that support the author's recommendation. This action ensures that decisions are based on a comprehensive understanding of the topic rather than relying solely on one source. By exploring other peer-reviewed articles, the nurse can validate the proposed change and make informed decisions regarding patient care. Choice A, implementing the article's recommendations, may not encompass a thorough evaluation of the information presented. Choice B, presenting the article to the nurse manager, is a valid step but does not directly involve critical analysis of the information. Choice D, disregarding the article, goes against the essence of critical thinking, which emphasizes the evaluation and consideration of various perspectives.

4. The nurse overhears a physician yelling at a newly hired graduate nurse in the hall. What is the nurse's best caring response?

• A. Yell at the physician for yelling at a new graduate and report the incident to the supervisor.
• B. Wait until the situation ends and comfort the graduate privately.
• C. Suggest that the physician take a quieter and more private approach to the problem.
• D. Ignore the situation to avoid embarrassing the graduate further.

Correct answer: C

Rationale: Suggesting a quieter and more private approach to the problem is the best caring response as it addresses the issue respectfully. This response shows empathy towards the graduate nurse and also aims to improve the situation without escalating it further. Choice A is not ideal as responding to yelling with yelling can exacerbate the situation and create more tension. Choice B, while offering comfort, does not directly address the inappropriate behavior of the physician. Choice D is not recommended as ignoring the situation may not help the graduate nurse and can lead to the continuation of inappropriate behavior without intervention.

5. What factor has had the greatest impact on the current nursing shortage?

• A. Later age at which women have children
• B. Decrease in the number of women being born
• C. Overall unemployment rate
• D. Increased employment options for women

Correct answer: D

Rationale: The correct answer is D. The increased employment options for women have had a significant impact on the current nursing shortage. With more career choices available to women, there is a decrease in the number of individuals pursuing nursing as a profession, contributing to the shortage. This is because women are choosing diverse career paths due to increased opportunities. Choices A, B, and C are incorrect. A later age at which women have children and the decrease in the number of women being born are not directly related to the nursing shortage. The overall unemployment rate, while influencing job availability, is not the primary factor driving the shortage of nurses.

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