ATI RN
Ethics and Issues in Contemporary Nursing Questions
Question 1 of 9
A concern that nurses were being asked to perform tasks that went beyond the state's nurse practice act was brought to the union's attention. Nurses were informed that either mediation or binding arbitration will be used to resolve the issue. A novice nurse asks about the difference between these techniques and is informed that:
Correct Answer: B
Rationale: The correct answer is B because binding arbitration involves a formal discussion where the arbitrator's recommendations are compulsory, meaning both parties must abide by the decision. This ensures a resolution to the issue at hand. A is incorrect because mediation is not necessarily sanctioned by the NLRB for formal discussions. C is incorrect because mediation does not typically result in a legally binding plan; it is a negotiation process to reach a mutually acceptable agreement. D is incorrect because binding arbitration does not specifically focus on the least destructive approach or self-governance by employees; it is about reaching a binding decision by a neutral third party arbitrator.
Question 2 of 9
A Mexican-American patient is attacked and beaten. This patient is at risk for "fright disease," which is known as:
Correct Answer: A
Rationale: The correct answer is A: susto. Susto is a cultural-bound syndrome in Mexican-American culture characterized by emotional distress due to a frightening or traumatic experience. This patient, having been attacked and beaten, is at risk for susto due to the emotional impact of the incident. Empacho refers to indigestion, bilis to anger, and mal ojo to the evil eye, none of which are directly related to the emotional distress caused by a traumatic event like in the case of susto.
Question 3 of 9
A nurse caring for a patient with anemia and heart failure prepares to hang a unit of packed red blood cells and realizes her break is in 5 minutes. She decides it is not necessary to have another nurse check the blood against the patient's information since the patient's blood type is O+ which she incorrectly remembered to be the universal donor. She hangs the blood, noting the patient is "reading and vital signs normal." She leaves the floor for her break and does not report leaving or ask anyone to perform required vital signs. Upon returning she meets a family friend who is visiting and time "just flies." She returns to the patient's room after admitting a new patient. The patient is hypotensive and color is cyanotic and anxious. She reports the findings to the charge nurse, who then contacts the physician. A blood reaction occurrence is noted. The nurse providing care is charged:
Correct Answer: C
Rationale: The correct answer is C: with criminal negligence. The nurse displayed a reckless disregard for the patient's safety by not verifying the blood type, leaving for an extended break without ensuring proper monitoring, and failing to report her absence. These actions were highly irresponsible and demonstrated a severe lack of care and attention to the patient's well-being. Criminal negligence involves a conscious disregard for the consequences of one's actions, which in this case resulted in a serious adverse event for the patient. Choices A and B do not fully capture the gravity of the nurse's actions, as they imply a lesser degree of fault. Choice D, under the doctrine of res ipsa loquitur, would be inappropriate in this scenario as the nurse's actions directly contributed to the adverse outcome.
Question 4 of 9
A patient is eligible to change health care providers and insurance and asks, "I am interested in health promotion activities; I walk, swim, and eat healthy. Which health insurance plan would support these activities rather than just pay for services when I am sick"? Which, if any, health insurance plan would best meet the needs of this patient?
Correct Answer: A
Rationale: The correct answer is A: Health Maintenance Organization (HMO). HMOs focus on preventive care and health promotion activities, such as regular check-ups, screenings, and wellness programs. They emphasize keeping patients healthy and offer incentives for healthy behaviors. This aligns with the patient's interest in health promotion activities like walking, swimming, and eating healthy. Choice B (Fee for Service) typically does not emphasize preventive care and may not provide the support for the patient's health promotion activities. Choice C (Preferred Provider Organization - PPO) may offer some preventive care services, but HMOs are more structured and proactive in promoting health and wellness. Choice D is incorrect because many health insurance plans, including HMOs, cover preventive care and health promotion activities to encourage overall well-being.
Question 5 of 9
A nurse manager is working with the financial officer to develop the budget of the nursing unit for the next fiscal year. The nurse manager tells the financial officer that which of the following pieces of information will affect budget assumptions?
Correct Answer: B
Rationale: The correct answer is B because an increase in patient census directly impacts the budget assumptions by affecting staffing needs, supply costs, and revenue projections. This information is crucial for accurate budget planning. Choice A is incorrect because the capital budget request for new equipment does not directly impact the nursing unit's operational budget assumptions. Choice C is incorrect as the effectiveness of participatory budgeting in controlling supply costs does not directly influence future budget assumptions. Choice D is incorrect as zero-based budgeting efficiency does not directly address the impact of increased patient census on budget assumptions.
Question 6 of 9
The priority intervention to improve work-related quality of life for nurses is to:
Correct Answer: A
Rationale: The correct answer is A: provide safe harbors for unjust or unsafe work assignments. This is the priority intervention because ensuring a safe work environment is crucial for nurses' well-being and quality of life. By addressing unjust or unsafe work assignments, nurses can feel supported and protected, leading to improved job satisfaction and overall quality of life. Option B: improving nurse-physician communications is important but not as critical as ensuring a safe work environment. Option C: requiring professional development courses is beneficial but may not directly address the immediate concerns of nurses' quality of life. Option D: improving vertical working relationships is important, but addressing unsafe work conditions should take precedence for nurses' well-being.
Question 7 of 9
In a large health care facility, the executive administrative leaders set the budget goals to decrease full-time equivalents by 3%, eliminate the cost of agency nurses, reduce lost revenue from lost supplies by 1%, and provide a 5% hourly salary incentive for working on a float unit when the assigned unit has a low census. Nurse managers meet with nursing administrators to design their unit budgets to meet these established goals. The budget approach that is being used is the approach.
Correct Answer: B
Rationale: The correct answer is B: participatory. This is because the nurse managers are actively involved in designing their unit budgets to meet the established goals set by the executive administrative leaders. In a participatory budgeting approach, input and collaboration from lower-level managers or staff members are encouraged, allowing for a more inclusive and bottom-up decision-making process. This approach fosters ownership, accountability, and transparency in budget planning. Summary of other choices: A: top-down - This approach involves setting budget goals and directives from the top management without much input or involvement from lower-level managers. Not applicable in this scenario. C: iterative - This approach involves making continuous adjustments and refinements to the budget based on feedback and performance data. Not explicitly mentioned in the scenario. D: incremental - This approach involves making small adjustments to the previous budget period. While there may be some incremental changes, the scenario emphasizes a more collaborative process involving nurse managers, making this choice less suitable.
Question 8 of 9
The emergency response team responded to a terrorist attack where hundreds of people died following symptoms of chest tightness, palpations, seizures, and finally paralysis. A colorless odorless liquid known as Sarin (GB) was the agent, which is primarily inhaled with limited exposure through the skin. The concentration of Sarin has not been measured. What level is the minimum level of personal protection and safety equipment (PPE) that would be needed?
Correct Answer: B
Rationale: The correct answer is B: Level B. In a scenario involving Sarin, a highly toxic nerve agent primarily inhaled, Level B protective equipment is required. Level B PPE includes a chemical-resistant suit, chemical-resistant gloves, chemical-resistant boots, and a full-face respirator with appropriate filter cartridges. The choice of Level B is based on the fact that Sarin is primarily inhaled, indicating the need for respiratory protection. Level A is typically used for the highest level of protection, including protection against highly toxic chemicals in both the air and on the skin, which is not necessary in this scenario. Level C and D do not provide adequate protection against a highly toxic chemical like Sarin.
Question 9 of 9
Nurses on a unit met with the nurse manager as part of participatory budgeting. They ask, "What exactly is the difference between fixed and variable costs? Understanding this will help us better understand the budgeting process." The manager provides a definition and asks the staff to list types of direct and indirect cost. Which example would indicate a need for further teaching?
Correct Answer: C
Rationale: The correct answer is C because the nurse manager's salary is typically considered a fixed cost, not a variable cost. Fixed costs remain constant regardless of the level of production or activity, while variable costs change in direct proportion to the level of activity. The nurse manager's salary is a fixed cost because it remains the same regardless of how many nurses are employed or how many patients are being cared for. A: Fixed costs such as accreditation fees are correct examples. B: Fixed costs like the cost for the automated medication-dispensing system are also correct examples. D: Variable costs like the salary expense for registered nurses are correct examples. Therefore, choice C would indicate a need for further teaching as it misidentifies the nurse manager's salary as a variable cost when it should be classified as a fixed cost.