A nurse learns of a mass casualty disaster following a known terrorist attack. On arriving at the scene, the nurse knows that:

Correct Answer: B

Rationale: The correct answer is B because in a mass casualty disaster following a terrorist attack, the same ground rules practiced in other settings and during smaller crises will be applicable. This is because the scale and complexity of the disaster require established protocols and procedures to manage the situation effectively. Choice A is incorrect because the response of local hospitals may not necessarily be dictated by the federal government in such situations. Choice C is incorrect because assigning the least experienced nurses to triage patients based on their perceived risk or chances of survival is not ethical or effective. Choice D is incorrect because having multiple incident commanders can lead to confusion and delays in decision-making during a crisis.

Correct Answer: C

Rationale: Step-by-step rationale for why choice C (case manager) is correct: 1. A case manager coordinates referrals and services for patients with complex needs, such as this patient with diabetes and dementia. 2. In this scenario, the nurse is coordinating referrals to an endocrinologist and organizing physical therapy, which aligns with the role of a case manager. 3. Case managers ensure continuity of care and facilitate communication between different healthcare providers. 4. The nurse's role in organizing follow-up care and services for the patient falls under the responsibilities of a case manager. Summary of why other choices are incorrect: A: Informatics specialist - This role focuses on managing health information systems, not coordinating referrals and services for patients. B: Educator - While education may be a component of the nurse's role, the primary focus in this scenario is on coordinating referrals and services, which is more in line with a case manager's responsibilities. D: Quality manager - Quality managers focus on ensuring healthcare services meet quality standards

Correct Answer: C

Rationale: The correct answer is C because in the shock phase, nurses should focus on self-reflection and personal growth to cope effectively with the challenges. Asking what changes they can make to feel good about their career choice promotes self-awareness and resilience. Choices A and D focus on external factors, which may not address personal development. Choice B reflects a self-critical mindset, which can be detrimental to emotional well-being during the shock phase.

Correct Answer: C

Rationale: Ethics applied to nursing can best be defined as care based on what should be done in keeping with the values of the client (Choice C). This answer emphasizes the importance of respecting the client's values and preferences in decision-making, which is a fundamental aspect of ethical nursing practice. It involves considering the client's beliefs, culture, and autonomy when providing care. Other choices are incorrect: A: Doing what is best for the client (Choice A) is subjective and may not always align with the client's values. B: Making good decisions about care (Choice B) is vague and does not specifically address the ethical considerations related to the client's values. D: Rules for providing competent care based on scientific principles (Choice D) focus on clinical competence rather than the ethical dimension of nursing practice.

Correct Answer: D

Rationale: The correct answer is D because developing a 5-year plan that incorporates the clinical nurse leader aligns with strategic planning, which involves setting long-term goals and outlining strategies to achieve them. This action demonstrates forward-thinking and aligns with the organization's overall vision. A: Ensuring nurses understand organizational philosophy is important but does not specifically relate to strategic planning. B: Evaluating communication processes is more operational or tactical in nature, not directly tied to long-term strategic planning. C: Monitoring data from a quality management initiative is important for quality improvement but does not directly relate to future planning and strategy development.

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.

Correct Answer: B

Rationale: The correct answer is B: Perfectionism. This nurse's belief that all tasks must be performed faultlessly is indicative of perfectionism, which can lead to inefficiency and inability to prioritize tasks effectively. By attending a seminar on overcoming perfectionism, the nurse can learn strategies to manage time more efficiently and prioritize tasks based on their importance. Creativity (option A) is not directly related to the nurse's struggle with completing tasks. Failure (option C) does not address the root cause of the nurse's issue. Downtime (option D) does not address the underlying perfectionism that is hindering the nurse's time management.

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.

Correct Answer: A

Rationale: Rationale for Answer A: Signing a union authorization card authorizes the union to serve as the nurse's legal representative in labor negotiations and other matters. By signing, the nurse is indicating consent for the union to act on their behalf. This is a crucial step in the unionization process. Summary of Other Choices: B: Requesting additional information about collective bargaining does not require signing a union authorization card. C: Sharing information about grievances does not necessarily require signing a union authorization card. D: Deducting union dues from pay is a separate process that typically requires a separate authorization form, not the union authorization card.