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.

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: A

Rationale: The correct answer is A because it aligns with the 2012 National Patient Safety Goals, specifically the goal of improving the accuracy of patient identification. By asking the patient to confirm their name, type of surgery, and limb to be removed, the surgical team is ensuring that they have the correct patient and are performing the correct procedure. This protocol helps prevent errors and ensures patient safety. Option B is incorrect because asking for licensure and certification does not directly relate to patient safety or accurate patient identification. Option C is incorrect because relying solely on chart numbers or hospital numbers may not be sufficient to prevent errors in patient identification. Option D is incorrect because while marking the procedure site is important, relying solely on the patient to verify the correct site may not be as effective as having the healthcare team confirm this information with the patient.

Correct Answer: D

Rationale: The correct answer is D because informed consent requires the registered nurse (RN) to communicate all necessary information to the patient so they can make an informed decision. This includes explaining the procedure, potential risks, benefits, alternatives, and any other pertinent information. The RN plays a crucial role in ensuring that the patient understands the information provided before giving consent. Choices A, B, and C are incorrect because informed consent is not solely mandated by federal law, must disclose risks as well as benefits, and should not involve concealing any known risks.

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: A

Rationale: The correct answer is A: direction and communication. The RN failed to provide clear direction to the LPN regarding the specific type of enema to be administered and the amount. Furthermore, there was a lack of communication regarding the patient's current condition and the rationale for the enema. The other choices are incorrect because: B: task - The task of administering the enema was clearly communicated. C: person - The patient was identified by room number, so the person was specified. D: circumstances - While the circumstances of the patient's complaint were mentioned, the specific details related to the enema administration were lacking.

Correct Answer: B

Rationale: The correct answer is B because a constituent refers to a citizen who is registered and eligible to vote for a representative. In this scenario, the nursing student is calling the office of an elected official, indicating that they are a citizen who can vote for that official. Choice A is incorrect as it refers to a member of a professional organization, not a citizen eligible to vote. Choice C is incorrect as it refers to an elected official, not a citizen. Choice D is incorrect as it refers to a member of the House of Representatives, not a citizen eligible to vote.

Correct Answer: A

Rationale: The correct answer is A: Caring for an aging population. This is a uniquely twenty-first-century issue as advancements in healthcare have increased life expectancy, leading to a larger elderly population with complex healthcare needs. Nurses must adapt their skills and knowledge to provide specialized care for this demographic. B: Increased patient acuity is a common challenge but not unique to the twenty-first century. Nurses have always dealt with varying levels of patient acuity. C: Access to health care services is an ongoing issue that has been prevalent for many years, not specifically unique to the twenty-first century. D: Expanding technology is also a significant challenge for nurses in the modern era, but it is not uniquely a twenty-first-century issue as technology has been advancing for decades.

Correct Answer: B

Rationale: The correct answer is B because binding arbitration involves a formal discussion where the arbitrator's recommendations are compulsory, meaning both parties must abide by the decision. This ensures a resolution to the issue at hand. A is incorrect because mediation is not necessarily sanctioned by the NLRB for formal discussions. C is incorrect because mediation does not typically result in a legally binding plan; it is a negotiation process to reach a mutually acceptable agreement. D is incorrect because binding arbitration does not specifically focus on the least destructive approach or self-governance by employees; it is about reaching a binding decision by a neutral third party arbitrator.