Correct Answer: A

Rationale: The correct answer is A: aspirin order within 24 hours of discharge. This is a key clinical indicator for evaluating care of heart attack patients as aspirin is a standard treatment to prevent further cardiac events. It is crucial for patient safety and adherence to national guidelines. Choice B is incorrect as patient teaching on smoking cessation, although important, is not a direct clinical indicator for evaluating care of heart attack patients. Choice C is incorrect as beta blocker administration upon arrival is important for heart attack patients, but it is not specific to evaluating the hospital's care compared to national standards. Choice D is incorrect as employer support for stress modification is not a clinical indicator relevant to evaluating care of heart attack patients.

Correct Answer: B

Rationale: The correct answer is B: cultural self-assessment. This is important as it helps the nurse understand their own beliefs, values, and biases, which can impact how they interact with culturally diverse clients. By being self-aware, the nurse can better recognize and address any potential cultural misunderstandings or conflicts. A: Taking a sign language course is not the priority as not all culturally diverse clients are deaf or use sign language. C: While cultural client assessment is important, it is secondary to the nurse understanding their own cultural biases first. D: Taking a course on how to speak Spanish is helpful but may not address the broader cultural competence needed to work with diverse clients.

Correct Answer: C

Rationale: The correct answer is C because nursing judgment related to withholding medication based on vital signs requires critical thinking, clinical knowledge, and experience. This decision-making process involves assessing the patient's condition, interpreting vital signs, and determining if medication should be given or withheld to ensure patient safety. This function cannot be delegated to someone without the appropriate training and expertise. A: Assessment of skin integrity on the third day of hospitalization can be delegated to other healthcare team members such as LPNs or nursing assistants, as long as they have been trained and deemed competent. B: Evaluation of patient teaching related to turn, cough, and deep breathing exercises can be delegated to other healthcare team members, as long as they have the appropriate training and supervision. D: The statement that RNs do not delegate to other RNs is incorrect. RNs can delegate certain tasks to other RNs based on their scope of practice and level of experience. It is not limited to LPNs or unlicensed assistive personnel.

Correct Answer: C

Rationale: The correct answer is C: Participatory. In participatory budget development, input is gathered from various levels within the organization, such as staff and managers. In this scenario, the nurse manager met with her staff to establish strategic goals before budget negotiations, indicating a participatory approach. This allows for staff buy-in and ownership of the goals. A: Iterative budget development involves refining a budget through multiple rounds of review, which is not explicitly mentioned in the scenario. B: Top-down budget development is characterized by decisions made by upper management without input from lower levels, contradicting the scenario where staff provided input. D: Zero-based budgeting starts from scratch without considering previous budgets, which is not evident in the scenario where goals were established based on staff input. In summary, the participatory budget development is the appropriate choice in this scenario as it aligns with the collaborative approach taken by the nurse manager and her staff in setting strategic goals before budget negotiations.

Correct Answer: A

Rationale: The correct answer is A because informed consent documents must provide participants with an explanation of potential risks and benefits to ensure they fully understand what they are agreeing to. This helps participants make an informed decision about participating. Option B is incorrect because using medical terminology can actually increase misunderstanding; lay terms are recommended. Option C is incorrect as it is essential to include a statement on protecting anonymity and confidentiality to ensure participant privacy. Option D is incorrect as explaining the cost of the study is not a necessary component of informed consent.