A nurse is caring for four clients in the medical-surgical inpatient unit. One is a Black woman who has been admitted with pancreatitis, another is a White man who has been admitted with acute low back pain, the third is a Black man with pneumonia, and the fourth is a White woman who has been admitted with cholecystitis. The nurse medicates the Black woman with one oral Percocet tab for 8/10 pain, medicates the White man with two oxycodone tabs for 7/10 pain, does not medicate the Black man as he does not have current pain, and medicates the White woman with 2 mg of IV morphine for 8/10 pain. What is this an example of?

Correct Answer: B

Rationale: The correct answer is B: Implicit bias. Implicit bias refers to unconscious attitudes or stereotypes that affect our actions and decisions. In this scenario, the nurse's decision to medicate the Black woman with less potent pain medication compared to the White man with more potent pain medication could be influenced by implicit bias. The nurse may have assumed the Black woman needs less pain relief or may have unconsciously prioritized the White man's pain over hers. This highlights how biases can impact healthcare decisions. Summary: A: Explicit racism is not demonstrated in the scenario as there is no overt discrimination based on race. C: Professional standard of care could be argued, but the unequal treatment based on race suggests bias rather than following professional standards. D: Structural racism involves systemic inequalities, which are not directly evident in this scenario.

Correct Answer: A

Rationale: The correct answer is A. Differences in health insurance coverage and access are key factors in the maternal mortality crisis. Limited access to quality healthcare due to lack of insurance can lead to delayed or inadequate prenatal care, increasing risks for maternal mortality. B: Income level may indirectly impact access to healthcare, but the lack of insurance coverage is a more direct barrier. C: Provider discrimination may contribute to disparities in care but is not as central to the issue of maternal mortality as access to insurance. D: Distrust in the medical system can be a barrier to seeking care but is not as significant as the lack of insurance coverage in the context of maternal mortality.

Correct Answer: B

Rationale: With the rapid growth of technology and increased demands on the private and public health care subsystems, health care costs have become prohibitive. Cost-effectiveness and cost containment have become critical driving forces as health care delivery system changes are made; however, cost-effectiveness often conflicts with the provision of quality care.

Correct Answer: D

Rationale: Managed care has become a dominant paradigm in health care. This model has replaced fee for service by a physician in independent practice or physicians in a group practice, and care in a community health center.

Correct Answer: D

Rationale: Voluntary health agencies are committed to specific diseases, organ or body structures, health and welfare of special groups, or particular phases of health. Philanthropic groups support research and programs. These organizations provide major sources of help in preventing disease, promoting health, treating illness, consumer education, and advocacy and research. Unfortunately, there continue to be overlaps among private, voluntary, and public agencies, but without voluntary agencies, fewer services would be available.