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. A healthcare professional walks into the nurse's station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions should the healthcare professional take first?

• A. remind the staff members that this is a breach of confidentiality
• B. discuss the issue with the unit manager
• C. request that an administrative restriction be placed on the client's medical access
• D. prepare a report for the facility ethics committee

Correct answer: A

Rationale: The correct action for the healthcare professional to take first is to remind the staff members that accessing the electronic medical record of a celebrity client from another unit is a breach of confidentiality. This immediate action addresses the ethical and legal issue at hand, emphasizing the importance of patient confidentiality and privacy. Discussing the issue with the unit manager, requesting administrative restrictions, or preparing a report for the facility ethics committee can be considered after addressing the initial breach and reminding staff members of their obligations.

3. 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.

4. The nurse listens as the physician asks the patient to participate in a research study and realizes the physician is not adequately explaining the risks of the study. As they leave the patient's room, the nurse encourages the physician to go back and explain the risks more thoroughly. What role is this nurse playing in patient care?

• A. Teacher
• B. Caregiver
• C. Advocate
• D. Communicator

Correct answer: C

Rationale: The nurse is acting as an advocate by ensuring the patient is fully informed before consenting to participate in the study. Advocacy in healthcare involves supporting and promoting the patient's rights, including the right to be fully informed about their care and treatment options. By advocating for the patient in this scenario, the nurse is prioritizing the patient's well-being and autonomy. Choices A, B, and D are incorrect. The nurse is not acting as a teacher, caregiver, or communicator specifically in this scenario, but rather advocating for the patient's right to informed consent.

5. Which historical figure is honored for working to improve care of the mentally ill in mental health nursing?

• A. Clara Barton
• B. Florence Nightingale
• C. Dorothea Dix
• D. Lillian D. Wald

Correct answer: C

Rationale: Dorothea Dix is the correct answer. She is recognized for her significant contributions in advocating for the improvement of care for the mentally ill. Dix played a crucial role in establishing mental health institutions and reforming the care provided to individuals with mental health conditions. Clara Barton is known for founding the American Red Cross, Florence Nightingale is renowned as the founder of modern nursing, and Lillian D. Wald is recognized for her work in public health nursing. However, none of them are specifically honored for their work in improving care for the mentally ill in mental health nursing, unlike Dorothea Dix.

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