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. 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.

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. What is a major source of stress on the current U.S. healthcare system?

• A. Rising cost of providing healthcare to all citizens
• B. Lack of adequate education for healthcare professionals
• C. Inadequate number of hospital beds across the country
• D. Increasing cost of malpractice insurance

Correct answer: A

Rationale: The increasing cost of providing healthcare to all citizens is a major source of stress on the current U.S. healthcare system. This rise in costs impacts various aspects of the system, including accessibility, quality of care, and financial sustainability. It affects healthcare providers, patients, insurance companies, and the government, making it a critical issue that needs to be addressed to ensure a more efficient and effective healthcare system. Choices B, C, and D are incorrect because although lack of education for healthcare professionals, inadequate number of hospital beds, and increasing malpractice insurance costs can be challenges within the healthcare system, they are not the primary source of stress that affects the system as a whole.

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