The key to organizational success for health care facilities is:

Correct Answer: D

Rationale: The correct answer is D: retaining professional nurses. Retaining professional nurses is crucial for organizational success in healthcare facilities as it ensures continuity of care, promotes staff morale, reduces turnover costs, and maintains high-quality patient outcomes. By retaining experienced and skilled nurses, organizations can benefit from their expertise, knowledge, and commitment to providing excellent patient care. A: Hiring younger, more energetic nurses may bring new perspectives and energy but does not guarantee the same level of experience and expertise as professional nurses. B: Offering incentives like sign-on bonuses may attract new hires, but it does not address the underlying issues that lead to nurse turnover. C: Hiring highly qualified advanced practice nurses is beneficial, but it does not address the importance of retaining all professional nurses within the organization.

Correct Answer: A

Rationale: Step-by-step rationale for why answer A is correct: 1. Professional duty: Nurses have a duty to provide patient-centered care regardless of personal beliefs. 2. Legal liability: Withholding treatment based on personal beliefs can lead to legal consequences. 3. Ethical considerations: Nurses must prioritize patient care over personal beliefs. 4. Rights of conscience: Nurses may have the right to refuse to participate in certain treatments, but they must still ensure patient care. 5. Patient-centered care: Nurses must respect patient autonomy and provide care based on the patient's wishes. Summary of why the other choices are incorrect: B. Irrelevant to the nurse's duty to provide patient-centered care. C. Nurses should not impose their beliefs on patients but should respect and support their choices. D. Suggesting the hospital not accept federal funding does not address the nurse's duty to provide patient-centered care.

Correct Answer: A

Rationale: The correct answer is A: Watson's philosophy and science of caring and humanistic nursing. This theory emphasizes the importance of the nurse-client relationship, caring, and holistic care. In this scenario, obtaining a guide dog for the client reflects the nurse's caring actions to promote the client's independence and well-being. By helping the client cope with the handicap and continue daily activities, the nurse embodies the essence of caring and humanistic nursing. Incorrect Choices: B: Mishel's uncertainty in illness - This theory focuses on how individuals respond to uncertainty in illness situations, which does not directly apply to the scenario of obtaining a guide dog for a blinded client. C: Orem's self-care deficit - This theory emphasizes the nurse's role in assisting clients with self-care activities when they are unable to do so independently. While related to the scenario, it does not capture the essence of caring and humanistic nursing demonstrated in the client's situation. D: Rogers' science of unitary human beings - This

Correct Answer: D

Rationale: The correct answer is D: capitated. In a capitated payment system, the physician receives a fixed amount per patient regardless of the services provided. This incentivizes cost-effective care and promotes preventive measures. In this scenario, the physician is receiving revenue for each procedure billed, which is not characteristic of capitated payment. A: Prospective payment is when a fixed amount is determined in advance for specific services rendered. This is not the case in the scenario provided. B: Retrospective payment involves reimbursement after the services are provided, which is not reflected in the scenario given. C: Diagnosis-related group (DRG) is a payment system used in hospitals based on the diagnosis and procedures performed, not applicable to individual physician billing as presented in the question.

Correct Answer: C

Rationale: The correct answer is C because autonomy in palliative care emphasizes the patient's right to make decisions about their own care. By helping the patient decide on the details of their advanced plan of care, healthcare providers respect the patient's autonomy and ensure their preferences guide the care provided. Arranging in-home health care (A) may be beneficial, but it does not directly support the patient's autonomy. Addressing pain management needs (B) is important but does not specifically relate to decision-making autonomy. Conducting a performance status screening (D) is relevant for assessing the patient's overall health but does not directly support their autonomy in decision-making.

Correct Answer: B

Rationale: The correct answer is B: stop the LPN/LVN immediately and discuss the possible consequences of his actions in a nonjudgmental manner. This is the priority intervention because it addresses the immediate issue of potentially incorrect documentation and allows for clarity and understanding between the RN and LPN/LVN. It promotes open communication and a chance to correct any errors that may have occurred. Choice A is incorrect because checking the drug packages after the fact does not address the issue of potentially incorrect documentation and missed medications. Choice C is incorrect as it is an extreme response that does not promote a collaborative and educational approach to resolving the situation. Choice D is incorrect as calling the pharmacy for replacement medications is not necessary at this stage and does not address the immediate concern of potentially incorrect documentation.

Correct Answer: D

Rationale: The correct answer is D: Biofeedback. Biofeedback is a type of CAM that involves using electronic devices to help individuals gain awareness and control over physiological processes, such as heart rate and muscle tension. In this case, the older adult is using imagery as a form of biofeedback to alter the dysrhythmia. Ayurveda (A) and Dosha (B) are traditional Indian systems of medicine based on balancing bodily energies, not directly related to using imagery for heart rhythm control. Homeopathy (C) is a system of alternative medicine based on the concept that "like cures like" and uses highly diluted substances, not imagery or biofeedback techniques.

Correct Answer: B

Rationale: The correct answer is B: clinical pathways. Clinical pathways are structured, evidence-based plans of care that outline the expected recovery milestones and interventions for a specific condition or procedure. By following a clinical pathway, nurses can effectively plan care and monitor progress based on established guidelines. Patient classification systems (A) categorize patients based on acuity levels, not recovery milestones. Functional nursing (C) involves delegating specific tasks to different staff members. Case management (D) focuses on coordinating care across multiple providers, not specifically on recovery milestones.

Correct Answer: C

Rationale: The correct answer is C because the crisis communication officer's primary responsibility is to provide clear and factual information about the event within the facility and potentially to the news media. This helps to ensure transparency, maintain credibility, and prevent misinformation. Choice A is incorrect as containing facts within the administration group limits transparency. Choice B is incorrect as inciting panic is counterproductive. Choice D is incorrect as withholding information until confirmed by state and federal agencies may lead to unnecessary delays in communication.