A client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?

Correct Answer: B

Rationale: The correct answer is B: Total quality management. This philosophy focuses on involving all employees in improving processes and products to achieve customer satisfaction. In this scenario, the nurse is prioritizing the client's needs and preferences, which aligns with the core principles of total quality management. Choice A, continuous quality improvement, focuses on incremental improvements over time rather than immediate customer satisfaction like in this case. Choice C, Six Sigma, emphasizes reducing defects in processes, not necessarily addressing individual customer preferences. Choice D, quality management, is a broader term that encompasses various approaches to ensuring quality but does not specifically highlight customer-centric care like total quality management does.

Correct Answer: D

Rationale: The correct answer is D: Determine whether the employee is aware of the policy. This step is crucial as it helps establish if the violation was intentional or due to lack of knowledge. By assessing the employee's awareness, you can tailor the appropriate response, which may include providing training or counseling. A: Terminate the employee is incorrect as it is an extreme measure usually taken as a last resort. B: Confront the employee is incorrect as it may lead to a defensive reaction without understanding the root cause. C: Discipline the employee immediately is incorrect as it assumes guilt before investigating the situation. In summary, option D is the correct initial step as it promotes fairness, understanding, and a constructive approach to addressing policy violations.

Correct Answer: D

Rationale: The correct answer is D because asking construction workers to be responsible for the equipment and sharp items is not within the charge nurse's role or responsibility. The charge nurse should notify the nursing supervisor (A) for immediate guidance and support, notify security (B) to ensure a safe environment, and have staff check patients (C) to verify safety measures. By asking the construction workers to be responsible, it shifts the burden away from the healthcare team and does not address the immediate safety concerns effectively. Each of the other choices directly addresses the issue at hand and involves proper escalation procedures for handling the situation.

Correct Answer: A

Rationale: The correct answer is A: Statutory laws. Statutory laws are enacted by legislative bodies and specifically regulate nursing practice. They outline the scope of practice, licensure requirements, and standards of care for nurses. Common laws (B) are based on court decisions and may not directly govern nursing practice. Administrative laws (C) deal with regulations set by government agencies but do not solely govern nursing practice. Constitutional laws (D) pertain to the fundamental rights and freedoms of individuals and are not specific to regulating nursing practice.

Correct Answer: C

Rationale: The main focus of Six Sigma methodology in healthcare is enhancing clinical decision making. This is because Six Sigma aims to reduce variation and defects in processes, leading to improved quality and outcomes. By focusing on clinical decision making, healthcare providers can ensure that the most effective and evidence-based decisions are made, ultimately leading to better patient care. Explanation for other choices: A: Reducing healthcare costs - While Six Sigma can lead to cost reduction by optimizing processes, its primary focus is on quality improvement. B: Improving patient satisfaction - Although important, patient satisfaction is not the main focus of Six Sigma in healthcare. D: Increasing healthcare access - Six Sigma is more concerned with improving the quality and efficiency of healthcare delivery rather than increasing access to healthcare services.

Correct Answer: A

Rationale: The correct answer is A: Intragroup conflict. This type of conflict occurs within the same group or team, such as the staff of the medical-surgical unit. In this scenario, the disagreement about holiday scheduling is happening within the team, making it an intragroup conflict. Other choices are incorrect because intergroup conflict involves conflict between different groups, interpersonal conflict involves conflict between individuals, and intrapersonal conflict is conflict within an individual's own thoughts or emotions.

Correct Answer: B

Rationale: The primary goal of the Affordable Care Act (ACA) is to expand access to healthcare. This is evident through provisions such as Medicaid expansion, health insurance marketplaces, and subsidies for low-income individuals. By increasing access to healthcare services and coverage, the ACA aims to ensure that more people have the opportunity to receive necessary medical care. This goal aligns with the overarching aim of improving public health and reducing disparities in healthcare access. The other choices are incorrect because while the ACA includes measures to address healthcare costs, quality, and funding, its main focus and primary goal are centered around expanding access to healthcare for all individuals.

Correct Answer: B

Rationale: The correct answer is B: Total quality management. This philosophy focuses on involving all employees in improving processes and products to achieve customer satisfaction. In this scenario, the nurse is prioritizing the client's needs and preferences, which aligns with the core principles of total quality management. Choice A, continuous quality improvement, focuses on incremental improvements over time rather than immediate customer satisfaction like in this case. Choice C, Six Sigma, emphasizes reducing defects in processes, not necessarily addressing individual customer preferences. Choice D, quality management, is a broader term that encompasses various approaches to ensuring quality but does not specifically highlight customer-centric care like total quality management does.

Correct Answer: A

Rationale: The correct answer is A: Terminate. If a staff member does not respond to discipline, termination may be necessary to maintain discipline and uphold organizational policies. Confronting (choice B) may not always be effective in resolving the issue. Describing the behavior (choice C) may not lead to immediate action. Determining awareness (choice D) is not sufficient if the behavior continues. Termination is a last resort to ensure accountability and maintain a disciplined work environment.