A hospital converts to a system of care delivery in which RNs, LPNs, and unlicensed assistive personnel (UAP) are responsible for implementing a specific task, such as medication administration or personal hygiene, for the entire nursing unit. This type of delivery system is:

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Ethics and Issues in Contemporary Nursing Questions

Question 1 of 9

A hospital converts to a system of care delivery in which RNs, LPNs, and unlicensed assistive personnel (UAP) are responsible for implementing a specific task, such as medication administration or personal hygiene, for the entire nursing unit. This type of delivery system is:

Correct Answer: B

Rationale: The correct answer is B: functional nursing. In functional nursing, tasks are divided among different levels of nursing staff based on their skills and qualifications. This system is task-oriented, with each staff member responsible for a specific function, such as medication administration or personal hygiene, for the entire unit. This allows for efficient and specialized care delivery. A: Total patient care involves one nurse providing all aspects of care to a group of patients. C: Team nursing involves a team of healthcare professionals working collaboratively to provide care to a group of patients. D: Primary nursing assigns one nurse to oversee the care of a group of patients from admission to discharge.

Question 2 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 3 of 9

A nurse manager is mentoring a novice nurse manager in determining staffing needs. The mentor explains, "We must determine the acuity level of the patient by:

Correct Answer: B

Rationale: The correct answer is B because quantifying the amount and intensity of care required is essential to determine staffing needs based on patient acuity. This involves assessing the complexity and severity of patients' conditions, which directly impacts the level of care needed. Patient satisfaction (A) does not provide objective data on acuity. Examining skill mix (C) is important but not the primary factor in determining acuity. Hospital days (D) reflect length of stay, not acuity level.

Question 4 of 9

When should a follow-up letter be written to a recruiter?

Correct Answer: C

Rationale: The correct answer is C because following up a few days after the interview shows professionalism and eagerness. It allows you to express gratitude, reiterate your interest, and inquire about the next steps. This timing is crucial as it keeps you fresh in the recruiter's mind without being too pushy. Choice A is incorrect because it is more appropriate to send a thank-you letter after the interview, not before. Choice B is incorrect as waiting 2 weeks after not getting the job may be too late for effective follow-up. Choice D is incorrect because you should not assume you got the position without confirmation.

Question 5 of 9

An RN delegates to an experienced LPN/LVN the task of administering oral medications to a group of patients. The LPN/LVN accepts the assignment, and the RN knows that the LPN/LVN has had the training and has acquired the skills needed to complete the task. The RN then observes the LPN/LVN recording a patient's medication administration just before entering the patient's room. The priority intervention by the RN is to:

Correct Answer: B

Rationale: The correct answer is B: stop the LPN/LVN immediately and discuss the possible consequences of his actions in a nonjudgmental manner. This is the priority intervention because it addresses the immediate issue of potentially incorrect documentation and allows for clarity and understanding between the RN and LPN/LVN. It promotes open communication and a chance to correct any errors that may have occurred. Choice A is incorrect because checking the drug packages after the fact does not address the issue of potentially incorrect documentation and missed medications. Choice C is incorrect as it is an extreme response that does not promote a collaborative and educational approach to resolving the situation. Choice D is incorrect as calling the pharmacy for replacement medications is not necessary at this stage and does not address the immediate concern of potentially incorrect documentation.

Question 6 of 9

In deciding whether to say no to a request that involves a time commitment, the professional nurse must consider:

Correct Answer: A

Rationale: Step-by-step rationale for why choice A is correct: 1. Cost-benefit ratio involves weighing the benefits of saying yes against the costs of the time commitment. 2. Professional nurses must consider the impact on patient care, workload, and personal well-being. 3. By evaluating the cost-benefit ratio, nurses can make informed decisions aligned with professional responsibilities and ethical standards. Summary: Choice A is correct because it emphasizes a systematic approach to decision-making based on evaluating the overall impact of the time commitment. Choices B, C, and D are incorrect as they do not address the essential consideration of weighing costs and benefits in decision-making.

Question 7 of 9

A client arrives in active labor and exhibits toxemia with irregular fetal heart tones. The client is an immigrant and is uninsured. Which act would prevent the client from being transferred to another facility?

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.

Question 8 of 9

A task force is considering factors that contribute to high-quality safe staffing. Which statement reflects an understanding of the American Nurses Association's (ANA) recommendations?

Correct Answer: B

Rationale: The correct answer is B because it aligns with the ANA's recommendations for high-quality safe staffing. The nursing process involves assessment, diagnosis, planning, implementation, and evaluation, which are essential for achieving safe patient outcomes. By allowing RNs enough time to apply this process, they can make informed decisions that promote quality care. Choice A is incorrect because patient needs can fluctuate throughout the shift, so staffing levels must be flexible to adapt to changing demands. Choice C is incorrect as patient acuity levels may require more RNs to provide complex care, rather than relying solely on unlicensed personnel. Choice D is incorrect as having adequate RN staffing is crucial for patient safety and outcomes, and cutting RN numbers for cost-effectiveness can compromise care quality.

Question 9 of 9

If a nurse practicing in a mental health agency could only belong to one professional organization, what criteria could be used to select the organization with the biggest impact?

Correct Answer: B

Rationale: The correct answer is B: Specialty organizations such as the American Psychiatric Nurses Association lobby for higher education requirements for nurses. Rationale: 1. Specialty organizations like the American Psychiatric Nurses Association focus specifically on mental health nursing, ensuring targeted advocacy and support. 2. Lobbying for higher education requirements demonstrates a commitment to advancing the profession and improving the quality of care. 3. Higher education requirements can lead to better outcomes for patients and enhance the credibility and expertise of mental health nurses. Summary: A: The American Nurses Association may have a broad reach, but it may not prioritize mental health nursing specifically. C: State nursing associations may have limitations in lobbying power, focusing more on state-level issues. D: Professional organizations like AAHN, while valuable for preserving history, may not actively advocate for current professional development and standards.

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