An RN is counseled by the nurse manager regarding inappropriate delegation when the:

Correct Answer: C

Rationale: The correct answer is C because delegating the task of completing a plan of care to a float LPN/LVN for a stable patient is inappropriate. LPNs/LVNs have a different scope of practice compared to RNs and should not be assigned tasks related to developing care plans. This task requires critical thinking skills and assessment that are within the RN's scope of practice. A: A is incorrect because delegating the task of greeting and showing ambulatory surgery patients to their rooms is appropriate for a nursing assistant. B: B is incorrect because delegating the task of collecting a sputum specimen, once trained, is appropriate for a nursing assistant under the supervision of an RN. D: D is incorrect because delegating the task of performing a dressing change to a competent LPN/LVN is appropriate, as long as it falls within their scope of practice.

Correct Answer: B

Rationale: The correct answer is B: that the nurse/patient ratio prevents safe care. This answer is correct because inadequate nurse/patient ratios have been consistently identified as a major factor contributing to nurse dissatisfaction and burnout. When nurses are responsible for too many patients, they are unable to provide safe and effective care, leading to increased stress and job dissatisfaction. Explanation of other choices: A: Decreased pay for alternative shifts: While decreased pay may be a concern for some nurses, it is not typically cited as one of the most common reasons for leaving a position. C: Most facilities are choosing an all-RN staff, which decreases opportunities for advancement: While this may be a concern for some nurses, it is not as universally impactful as unsafe nurse/patient ratios. D: Agency and foreign nurses are favored by administration over full-time nursing staff: While favoritism may be an issue in some cases, it is not typically cited as one of the most common reasons for nurses leaving their employment.

Correct Answer: C

Rationale: The correct answer is C: a needs assessment method. A needs assessment method is used to identify gaps or deficiencies in services, programs, or resources in a community. In this scenario, the nurse is determining if there is a need for a hospice program, which aligns with the purpose of a needs assessment. A survey (choice A) involves collecting data from a sample group to gather insights, but it doesn't necessarily focus on identifying specific needs. Quasi-experimental (choice B) and pilot study (choice D) are research designs used to test interventions or programs, which are not the primary goal in this case.

Correct Answer: A

Rationale: The correct answer is A because the Nurses of America's media campaign aimed to highlight nurses as expert clinicians, emphasizing their skills, knowledge, and expertise in patient care. This choice aligns with the campaign's goal and message. Choice B is incorrect because the campaign did not specifically advocate for a higher nurse/patient ratio. Choice C is incorrect as the campaign sought to make nurses more visible in the news media. Choice D is incorrect because while nurses are caring, the focus of the campaign was on their clinical expertise.

Correct Answer: C

Rationale: The correct answer is C because the Palliative Performance Scale assesses functional status in palliative care. A patient with 70% normal function would have a score of 70 on the scale, indicating that they are still able to ambulate but with limitations due to their illness. Choice A is incorrect because inability to hold a job does not directly correlate with functional status. Choice B is incorrect as spending most of the day in bed suggests a lower level of functioning. Choice D is incorrect as being bed bound indicates a more severe impairment in function compared to a patient who can still ambulate with limitations.

Correct Answer: D

Rationale: The correct answer is D because as a patient approaches death, the focus of palliative care shifts towards providing comfort and symptom management to improve their quality of life. Identifying and addressing the patient's comfort needs becomes crucial in ensuring a peaceful and dignified end-of-life experience. A: While discussing spiritual needs can be important, the primary focus shifts towards physical comfort in the final stages of life. B: Educating the patient about physical changes is important, but it may not be the priority as the focus shifts towards comfort care. C: Advance care planning is essential but may have already been addressed before the patient reaches the impending death stage.

Correct Answer: B

Rationale: The correct answer is B because in Charles Dickens' novel, "Martin Chuzzlewit," Sairy Gamp is depicted as a character who chose nursing as a means of employment due to her lack of other opportunities. This is evident through her portrayal as a self-serving and unprofessional individual, focusing more on her own comfort and benefits rather than the well-being of her patients. Choices A, C, and D are incorrect because they do not align with the actual portrayal of Sairy Gamp in the novel, who is not depicted as a trained professional, a prostitute, or a forward-thinking nurse.

Correct Answer: C

Rationale: The correct answer is C because the Medicare Modernization Act (Medicare Part D) provided coverage for medications that constituted a huge expense for the elderly. This is crucial for the aging population as they often require multiple medications for chronic conditions. Choice A is incorrect because vision care benefits for legally blind individuals are usually covered under Medicare Part B. Choice B is incorrect as the act specifically focused on medication coverage, not mental health/substance abuse services. Choice D is incorrect as the act did not directly address expanding practice opportunities for APRNs, but rather focused on medication coverage for the elderly population.

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.