A novice nurse notices the medication nurse hurriedly gathering medications to be administered for the entire day, removing them from the packages, and placing them in a paper cup with the patient's name and room number on the cup. When one of the patients points at a pill and asks, "What is this?" and "What does this do?" the medication nurse is uncertain, because it has long since been removed from the packaging. The novice nurse speaks to the nurse manager about her observations and describes her concerns. The novice nurse has assumed the role of:

Correct Answer: C

Rationale: Correct Answer: C - Change agent Rationale: 1. A change agent is someone who identifies issues or concerns and takes action to implement positive changes. 2. In this scenario, the novice nurse recognized a potential problem with medication administration and spoke to the nurse manager to address it. 3. By seeking to improve medication safety practices, the novice nurse is actively working towards positive change within the healthcare setting. 4. The other choices are incorrect: - A "loner" implies someone who prefers to work alone, which is not relevant to the situation. - "Rutter" and "native" are not recognized terms in this context and do not apply to the nurse's actions.

Correct Answer: C

Rationale: Correct Answer: C - Change agent Rationale: 1. A change agent is someone who identifies issues or concerns and takes action to implement positive changes. 2. In this scenario, the novice nurse recognized a potential problem with medication administration and spoke to the nurse manager to address it. 3. By seeking to improve medication safety practices, the novice nurse is actively working towards positive change within the healthcare setting. 4. The other choices are incorrect: - A "loner" implies someone who prefers to work alone, which is not relevant to the situation. - "Rutter" and "native" are not recognized terms in this context and do not apply to the nurse's actions.

Correct Answer: A

Rationale: The correct answer is A: change agent. The nurse is acting as a change agent by identifying a problem (care being withheld until an interpreter arrives) and proposing a solution (teaching common medical terms in Spanish). As a change agent, the nurse is promoting positive change within the organization to improve patient care. The other choices are incorrect because: B: Educator - While the nurse is providing education, the primary role in this scenario is not solely that of an educator. C: Manager - The nurse is not directly managing staff or resources in this scenario. D: Coordinator - The nurse is not primarily coordinating activities or resources in this scenario.

Correct Answer: B

Rationale: The correct answer is B: active listening. Active listening involves fully focusing on the speaker, making eye contact, acknowledging what they are saying, and showing genuine interest in their words. In this scenario, the nurse is attentively listening to the patient's account of the events leading to chest pain, demonstrating active listening skills by being present in the moment and engaging with the patient's narrative. A: Assertive communication involves expressing one's thoughts and feelings clearly and respectfully. This choice is incorrect because the nurse is not actively expressing her thoughts or feelings in this situation. C: Empathy involves understanding and sharing the feelings of another. While empathy is important in nursing care, the nurse in this scenario is primarily engaged in listening rather than specifically expressing empathy. D: Passive communication is characterized by a lack of assertiveness and active engagement in the conversation. This choice is incorrect because the nurse is actively listening and engaging with the patient's narrative.

Correct Answer: A

Rationale: The correct answer is A: case management. Case management involves coordinating care for patients to ensure they receive appropriate services and resources. DRGs determine reimbursement based on patient diagnoses, making accurate classification crucial. Nurses in case management play a key role in ensuring patients are placed in the correct DRG category for optimal care and reimbursement. Other choices are incorrect because: B: Quality assurance focuses on monitoring and improving the quality of care, not specifically tied to DRG classification. C: Utilization review involves assessing the appropriateness and necessity of healthcare services, not directly related to DRG classification. D: Cost-control pertains to managing healthcare costs, but does not address the specific role of nurses in DRG classification and patient care coordination.

Correct Answer: B

Rationale: The correct answer is B: staffing. The nurse manager's concern is related to ensuring adequate numbers of RNs, LPN/LVNs, and UAPs per shift to meet patient needs. Staffing refers to the appropriate allocation of personnel to provide safe and effective care. Assignments (A) are specific tasks given to staff, output (C) is the end result of a process, and productivity (D) is efficiency in completing tasks - these are not the primary focus of the nurse manager's concern in this scenario. Staffing directly addresses the crucial aspect of having the right mix and number of staff members to deliver quality care.

Correct Answer: C

Rationale: The correct answer is C because nurses being voted as the most honest and ethical profession indicates their strong commitment to patient care and ethics. Therefore, nurses may find participating in strikes conflicting with their core values of serving and protecting patients. This conflict can deter nurses from engaging in union activities like strikes, as they prioritize patient well-being over their own interests. A is incorrect because while nurses prioritize client safety, participating in strikes may not always align with this goal. B is incorrect as evidence-based studies may support various perspectives, but nurses' ethical standards and commitment to patient care are the primary factors influencing their decision to engage in strikes. D is incorrect as legal repercussions for striking nurses focus on professional misconduct rather than the ethical dilemma nurses face when considering strikes.

Correct Answer: D

Rationale: The correct answer is D because when a nurse manager conducts a qualitative analysis of budget variances, they need to reconcile the underlying assumptions on which the budget was based with current conditions. This involves reviewing the initial budget assumptions to see if they still hold true and adjusting them accordingly. This step ensures that the budget remains relevant and accurate. A is incorrect because determining the percentage increase of supply usage does not involve a qualitative analysis of budget variances. B is incorrect because identifying the overall increase in the dollar amount of salaries paid for overtime is a quantitative analysis, not qualitative. C is incorrect because comparing productivity metrics across nursing units is a different type of analysis and not specifically related to budget variances.

Correct Answer: B

Rationale: The correct answer is B because it aligns with improving quality of care and cost containment. LPNs are trained to perform sterile procedures like dressing changes and IV tubing changes, which can enhance patient outcomes. This assignment allows the RN to focus on tasks that require their specialized skills, promoting quality care. Furthermore, utilizing LPNs for these tasks is more cost-effective than having an RN perform them. Choices A, C, and D are incorrect: A: Having the RN administer all medications to all patients is not utilizing the team effectively. LPNs and UAPs can handle medication administration under appropriate supervision. C: While experienced UAPs can assist with attaching telemetry electrodes, this task does not fully utilize the skills of the LPNs and RN to improve care quality. D: Administering an enema is within the scope of an LPN's practice, and assigning this task to the RN is not the most efficient use of resources.