Nursing Elites

1. 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.

2. What is the difference between mediation and binding arbitration based on the statement provided?

• A. Mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor
• B. Mediation uses a trained person to facilitate negotiations without making a final decision
• C. Binding arbitration is a formal process where an arbitrator's decision is final and must be adhered to by both parties
• D. Binding arbitration requires both labor and management to engage in discussions to find the least harmful resolution

Correct answer: C

Rationale: The key difference between mediation and binding arbitration lies in the finality of the decision. In binding arbitration, the arbitrator's decision is ultimate, and both parties are obligated to comply with it. This differs from mediation, where a neutral third party facilitates negotiations but does not make a final decision. Choice A is incorrect as mediation is not necessarily sanctioned by the NLRB; it can be conducted independently. Choice B is incorrect because mediation does not involve a final decision-maker but focuses on facilitating discussions. Choice D is incorrect as binding arbitration does not aim to find the least harmful resolution but rather a final and binding decision by the arbitrator.

3. Why is critical thinking necessary for identifying and understanding paradigms that exist in nursing practice?

• A. Critical thinking allows for the nurse to make superficial decisions.
• B. Critical thinking allows the nurse to thoroughly examine situations and issues.
• C. Critical thinking provides the nurse with quick answers.
• D. Critical thinking allows the nurse to accept information without needing to check its validity.

Correct answer: B

Rationale: Critical thinking is essential for nurses to identify and understand paradigms in nursing practice because it enables them to thoroughly examine complex situations and issues. By critically analyzing information and considering various perspectives, nurses can gain a deeper understanding of the underlying paradigms that shape nursing practice. This thorough examination helps nurses make informed decisions and provide high-quality care to patients. Choice A is incorrect because critical thinking involves deeper analysis, not superficial decisions. Choice C is incorrect because critical thinking does not provide quick answers; it involves a systematic and thoughtful approach. Choice D is incorrect because critical thinking encourages nurses to question information and verify its validity rather than accepting it blindly.

4. 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.

5. Which statement about the U.S. healthcare system made by the nurse is untrue and inaccurate?

• A. There is no central agency governing the healthcare system.
• B. Access to healthcare is available to all persons regardless of ability to pay.
• C. Legal risk must be considered when providing healthcare.
• D. High-tech equipment is available but payment for its use is troublesome to the system.

Correct answer: B

Rationale: The correct answer is B. Access to healthcare is not universally available to all persons in the U.S.; it is often influenced by the ability to pay. Choice A is accurate as there is no single central agency governing the entire U.S. healthcare system. Choice C is a valid consideration as legal risks are important in healthcare provision. Choice D highlights a common issue in the U.S. healthcare system where high-tech equipment is available, but the payment for its use can be problematic.

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