Nursing Elites

1. 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.

2. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

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. A group of workers wish to seek union representation that would protect all workers in the agency, including unlicensed assistive personnel and non-nursing employees such as a nutritionist and dietary workers. The type of union being sought is the strongest collective group and is known by what term?

• A. A right-to-work bargaining organization
• B. An occupational union
• C. Industrial unionism
• D. Union shop

Correct answer: C

Rationale: Industrial unionism refers to a union that represents all workers in a particular industry, regardless of their specific job roles. In this scenario, the workers are looking for a union that covers a wide range of employees in the agency, making industrial unionism the most suitable option. Choice A, 'A right-to-work bargaining organization,' is incorrect as right-to-work laws pertain to union security agreements and do not define the type of union being sought. Choice B, 'An occupational union,' is incorrect as it typically represents workers within a specific occupation, not across various roles as described in the scenario. Choice D, 'Union shop,' is incorrect as it refers to a workplace where employees are required to join or pay union dues as a condition of employment, which is different from the scenario described.

5. While working in the clinical facility, the student nurse learns that a family member has been admitted to the same facility. What statement is true about the student's access to the family member's medical record?

• A. The student may access the family member's medical record as a nurse in the facility.
• B. The student nurse should not access the family member's record until obtaining instructor approval.
• C. The student may access the family member's medical record because of the family relationship.
• D. The student nurse should not view the record unless they are providing care for the family member.

Correct answer: D

Rationale: The student nurse should not view the family member's record unless they are directly involved in providing care to maintain confidentiality. Accessing the record without a legitimate reason breaches patient confidentiality and violates ethical principles. Choice A is incorrect because being a nurse in the facility does not automatically grant access to a family member's record. Choice B is incorrect as it does not address the primary concern of direct involvement in care. Choice C is incorrect as family relationship alone does not justify accessing the medical record.

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