A novice nurse is stressed due to always being behind with her assignments. She is overheard saying, "No one here worries about checking nasogastric tube placement before they give medications and hang feedings. Skipping that step would save me an extra 30 minutes to be used for charting. If they can do it, so can I." This nurse is experiencing which stage of reality shock?

Correct Answer: D

Rationale: The correct answer is D, "native." In this scenario, the nurse is rationalizing skipping a crucial safety step by justifying it with the actions of others, indicating a lack of understanding regarding the importance of the procedure. The "native" stage of reality shock occurs when individuals start to adopt the norms and behaviors of their workplace without questioning or critically evaluating them. This nurse is displaying a mindset of conforming to unsafe practices to fit in with her colleagues, which aligns with the characteristics of the "native" stage. Incorrect choices: A: "loner" does not apply as the nurse is not isolating herself but rather seeking to emulate the actions of others. B: "rutter" does not fit as this stage involves feeling overwhelmed by the demands of the job, not justifying unsafe practices. C: "change agent" is not relevant as the nurse is not actively seeking to instigate change but rather conforming to existing practices.

Correct Answer: B

Rationale: The correct answer is B because the length of the NCLEX-RN exam is based on the location of testing. This is because different testing centers may have varying procedures, schedules, and regulations that can affect the overall length of the exam. The length is standardized by location to ensure fairness and consistency for all candidates. Incorrect Answers: A: The last four numbers of the candidate's social security number have no relevance to the length of the exam. C: The candidate's educational preparation may impact their readiness for the exam but does not determine the length of the exam. D: The performance of the candidate is assessed during the exam and does not determine the initial length of the exam.

Correct Answer: C

Rationale: The correct answer is C: case manager. A case manager coordinates resources to achieve optimal health outcomes for clients efficiently. They assess, plan, implement, and evaluate care while considering cost-effectiveness. Informatics specialists focus on data and technology, educators provide knowledge, and quality managers ensure high standards. In this scenario, the key role is coordinating resources, making C the best choice.

Correct Answer: D

Rationale: The correct answer is D: National Disaster Medical System (NDMS). This system is designed to provide medical care during disasters, including addressing mental health needs like posttraumatic stress syndrome in victims and compassion fatigue in care providers. NDMS coordinates federal medical response resources and personnel to support communities during disasters. A: Strategic National Stockpile focuses on providing medicines, vaccines, and medical supplies, but does not directly address mental health needs or provide medical care. B: Metropolitan Medical Response System (MMRS) focuses on local response capabilities for mass casualty incidents, but does not have the same scope as NDMS in providing comprehensive medical care. C: Commissioned Corps Readiness Force is a team of healthcare professionals within the U.S. Public Health Service, but it is not specifically designated for disaster medical response like NDMS.

Correct Answer: B

Rationale: The correct answer is B: those skills necessary for safe, competent nursing practice. Core competencies refer to the essential skills and knowledge required for safe and competent nursing practice. In the scenario provided, the nursing student needs to demonstrate proficiency in indwelling catheter insertion and wound care to meet these core competencies. These skills are crucial for providing quality patient care and ensuring patient safety. Choice A is incorrect because core competencies are not about reducing attrition but rather about ensuring students possess the necessary skills for nursing practice. Choice C is incorrect as core competencies focus on skills required for practice, not on educational remediation. Choice D is incorrect because core competencies are not about improving reading and math skills but about the specific nursing skills needed for practice.

Correct Answer: A

Rationale: The correct answer is A: Blocking. In both situations, the patient's actions are ignored or dismissed, indicating a lack of active listening. Blocking involves avoiding communication by not acknowledging the patient's gestures or needs. The nurse fails to engage with the patient and address their non-verbal cues. Summary: B: Filtration is not relevant as it involves selectively presenting information. C: Empathy is not demonstrated as the nurse is not responding to the patient's non-verbal cues. D: False assurance is not applicable as it involves giving misleading reassurance, which is not present in the scenario.

Correct Answer: C

Rationale: The correct answer is C: Insurance company. In the triad of health care, the third-party payer refers to an entity outside of the patient and health care provider that pays for the health care services. Insurance companies typically serve as third-party payers by covering a portion or all of the costs associated with medical treatments. The other choices (A, B, D) are not considered third-party payers in this context. Choice A refers to the client/patient receiving the health care services, choice B refers to the health care provider delivering the services, and choice D refers to a government agency that sets reimbursement rules but does not directly pay for the services rendered.

Correct Answer: A

Rationale: The correct answer is A: chronic obstructive pulmonary disease. This is because COPD is a leading cause of death among minority groups due to factors like smoking, pollution exposure, and healthcare disparities. This aligns with the grant's goal of improving health outcomes for minorities. Malnutrition (B) is not a top cause of death for minorities. Cirrhosis of the liver (C) is more common in certain populations but not a top priority for this grant. Cancer (D) is a significant concern, but COPD is more prevalent among minority groups.

Correct Answer: B

Rationale: The correct answer is B because conducting meetings at the worksite with respected staff nurses allows for direct engagement with potential union supporters. This approach fosters a sense of unity and trust among the nurses, making it easier to form a core support group. Additionally, meeting at the worksite enables easy access for all nurses and ensures a safe and neutral environment for discussions. Choices A, C, and D are incorrect because: A: Meeting away from the worksite with managers may create a conflict of interest and could lead to a biased understanding of the situation. C: Meeting in homes or local businesses may not provide a professional setting for discussions and may not be convenient for all nurses to attend. D: Photographing management meetings and discussing their strategies is unethical and could potentially harm the relationship between nurses and management.