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. Why is it important for healthcare professionals to have an understanding of healthcare issues in the United States?

• A. To ensure proper documentation of patient insurance information.
• B. Reimbursement policies often dictate the services that can be offered to the public.
• C. The quality of care provided is influenced by the patient's insurance coverage.
• D. Proficiency in healthcare issues is essential for graduating as a practical nurse.

Correct answer: B

Rationale: Understanding healthcare issues in the United States is crucial for healthcare professionals because reimbursement policies play a significant role in determining the services that can be provided to patients. By comprehending these issues, healthcare professionals can navigate the complexities of healthcare delivery, ensure appropriate services are offered, and optimize patient care outcomes. Choice A is incorrect because understanding healthcare issues goes beyond just documentation of patient insurance information. Choice C is incorrect as the quality of care should not be solely dependent on a patient's insurance coverage. Choice D is incorrect because while proficiency in healthcare issues is important for practical nurses, it is not a requirement solely for graduating.

3. How does the nurse apply Maslow's hierarchy of needs in care?

• A. Judging the patient's behavior
• B. Improving the skillfulness of care
• C. Understanding the patient's behavior
• D. Improving communication skills

Correct answer: C

Rationale: Maslow's hierarchy of needs is a framework that helps nurses understand the different levels of human needs and prioritize care accordingly. By applying this framework, nurses can better understand the patient's behavior in the context of their unmet needs. This understanding allows nurses to provide holistic and patient-centered care that addresses not just the physical but also the emotional, social, and psychological needs of the patient. Choice A is incorrect because applying Maslow's hierarchy is about understanding, not judging, the patient's behavior. Choice B is incorrect as it does not directly relate to the application of Maslow's hierarchy. Choice D is also incorrect as improving communication skills, although important, is not the primary focus when applying Maslow's hierarchy of needs in care.

4. On what basis does the U.S. healthcare system operate?

• A. Healthcare is a basic right provided to all equally.
• B. Ability to pay determines access to care.
• C. Only the rich are entitled to healthcare.
• D. Health insurance is required to obtain care.

Correct answer: B

Rationale: The correct answer is B. In the U.S., the healthcare system operates on a model where access to healthcare services is largely determined by an individual's ability to pay for care. This means that those with more financial resources have greater access to a wider range of healthcare services, while those with limited financial means may face barriers to accessing necessary care. Choices A, C, and D are incorrect because healthcare in the U.S. is not universally provided as a basic right to all equally, it is not exclusively for the rich, and while health insurance is common, it is not the sole determinant of access to care.

5. While supervising the care of several clients, which action requires intervention by the charge nurse?

• A. A nurse photocopies a client's diagnostic test results.
• B. An assistive personnel documents the client's vital signs on the client's paper-based graphic record.
• C. The unit secretary faxes a client's laboratory results to the provider.
• D. An RN stays with a client to discuss her understanding of her vital signs that were requested.

Correct answer: A

Rationale: The charge nurse should intervene when a nurse photocopies a client's diagnostic test results as it violates patient confidentiality and privacy. This action breaches HIPAA regulations, and sensitive patient information should not be photocopied without proper authorization. The other actions are within the scope of practice and do not raise concerns regarding patient privacy or confidentiality.

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