Correct Answer: A

Rationale: The correct answer is A: Emergency Medical Treatment and Active Labor Law (EMTALA). This act prohibits hospitals from transferring patients in active labor or with an emergency condition based on insurance status or ability to pay. It ensures that all individuals, regardless of insurance or immigration status, receive necessary emergency medical treatment. The other choices are incorrect because: B: Health Insurance Portability and Accountability Act (HIPAA) protects patient privacy and does not address transfer of patients in active labor. C: Patient Self-Determination Act focuses on patient autonomy in making healthcare decisions, not on preventing transfer based on insurance status. D: The Patient Safety and Quality Improvement Act promotes patient safety and quality improvement but does not specifically address transfer of patients in active labor.

Correct Answer: B

Rationale: The correct answer is B because in a mass casualty disaster following a terrorist attack, the same ground rules practiced in other settings and during smaller crises will be applicable. This is because the scale and complexity of the disaster require established protocols and procedures to manage the situation effectively. Choice A is incorrect because the response of local hospitals may not necessarily be dictated by the federal government in such situations. Choice C is incorrect because assigning the least experienced nurses to triage patients based on their perceived risk or chances of survival is not ethical or effective. Choice D is incorrect because having multiple incident commanders can lead to confusion and delays in decision-making during a crisis.

Correct Answer: A

Rationale: The correct answer is A because before addressing any ethical issue, it is vital to first identify and define the issue clearly. This helps in understanding the context and scope of the problem. Without knowing the specific ethical issue at hand, it is impossible to proceed with identifying alternatives, selecting the best option, or justifying the choice of action. Therefore, asking "What is the issue?" is the initial step in the ethical decision-making process. Summary: - Option B is incorrect because identifying alternatives comes after defining the issue. - Option C is incorrect as selecting the best option should be based on a clear understanding of the issue. - Option D is incorrect as justifying actions or inactions should come after determining the ethical problem.

Correct Answer: A

Rationale: The correct answer is A. Delegating the assessment of vital signs during the first 5 minutes of a blood transfusion to UAPs is not appropriate. This is because a reaction can occur within the first few minutes of a blood transfusion, making it crucial for a registered nurse to assess the patient during this critical period. UAPs do not have the education or training to recognize and manage potential adverse reactions promptly. Choice B is incorrect because an LPN/LVN can indeed administer a PPD if there is no history of a positive result. Choice C is incorrect because LPN/LVNs should not administer medications that have a high potential for adverse effects, such as dopamine. Choice D is incorrect as transferring a patient who is being discharged home requires skilled nursing assessment and intervention, not just training in transferring techniques.

Correct Answer: A

Rationale: The correct answer is A: organizational skills. The novice nurse's inability to assess the number of admissions and postoperative patients before requesting assistance indicates a lack of organizational skills. Organizational skills involve prioritizing tasks, managing time efficiently, and planning ahead. In this scenario, the nurse failed to gather essential information before making a decision, leading to inefficiency and potential misallocation of resources. Choice B: communication skills, is not the best answer because the issue is not primarily related to communication breakdown but rather a lack of organizational skills. Choice C: interpersonal skills, is not the best answer because the problem does not stem from the nurse's ability to interact with others but rather from her inability to organize her workload effectively. Choice D: clinical skills, is not the best answer because the situation is more about managing workload and resources rather than clinical knowledge or expertise.