Nursing Elites

1. When teaching about community preparedness for a community group, the nurse should explain that the components of the national disaster medical system (NDMS) provide assistance in what form?

• A. making available a nationwide bomb disposal squad team for the rapid removal of explosive devices
• B. Facilitating patient evacuation from the disaster area to a non-affected area
• C. organizing ground for detonation of bombs by bomb squad
• D. providing mental health care for victims and healthcare providers in the community

Correct answer: B

Rationale: The correct answers are B and C. The NDMS is designed to provide medical response during disasters, assist in patient movement, and offer definitive care to disaster victims. This includes organizing teams of healthcare providers with specialized skills and equipment to respond effectively to emergencies. Patient evacuation from disaster areas to safer locations is also a key function of the NDMS to ensure the well-being of those affected by the disaster. Options A and D are incorrect because the NDMS does not provide bomb disposal services and is primarily focused on medical response rather than mental health care.

2. How do accrediting agencies such as the Joint Commission ensure quality care?

• A. Imposing maximum staffing levels
• B. Stipulating nurse-patient ratios
• C. Confirming delivery of satisfactory care
• D. Requiring a specific staff mix

Correct answer: C

Rationale: Accrediting agencies such as the Joint Commission primarily focus on confirming the delivery of satisfactory care rather than imposing specific staffing levels, nurse-patient ratios, or staff mix. They do not dictate the exact staffing levels or ratios but rather evaluate if the care provided meets established quality standards. While adequate staffing levels and appropriate nurse-patient ratios are essential for quality care, accrediting agencies like the Joint Commission assess the outcomes and overall quality of care delivered by healthcare facilities.

3. 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.

4. Caring means responding to others as unique individuals, sensing their emotions, and accepting them as they are, unconditionally. This response accepts the patient's choice without condemning or frightening them.

• A. Finding a way for the patient to see the dog, even if they can only look out a window, shows caring by understanding this patient's needs.
• B. The definition of transpersonal caring includes accepting individuals for who they are, so a nonjudgmental attitude is essential.
• C. This statement includes the patient in planning care, demonstrating care for the patient's needs and preferences.
• D. Curative nursing care is high-tech, or nursing care that is based on the medical model of care, which often is based on the use of technology.

Correct answer: C

Rationale: The statement in option C aligns with the concept of caring described in the question. By including the patient in planning care, it demonstrates an understanding of and respect for the patient's individual needs and preferences. This approach fosters a patient-centered care environment, promoting better outcomes and patient satisfaction. Options A and B touch on aspects of caring but do not directly address the scenario described in the question. Option D introduces a different concept, curative nursing care, which is not relevant to the context of the question focused on patient-centered caring and acceptance.

5. 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.

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