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: The correct answer is A: Work with the patient and family to create an advanced plan of care. This is the best way to avoid ethical dilemmas because it involves proactive decision-making and communication among all parties involved. By creating an advanced plan of care, the patient and family can outline the patient's preferences, values, and goals for future care, ensuring that decisions align with the patient's wishes. This helps prevent potential conflicts and ensures that everyone is on the same page regarding the patient's care. Choices B, C, and D are incorrect: B: Explaining cognitive decline does not directly address how to avoid ethical dilemmas and may cause unnecessary distress. C: Discussing religious and spiritual concerns is important but may not specifically address future ethical dilemmas related to care decisions. D: Identifying family members in control of decision-making does not necessarily prevent ethical dilemmas and may overlook the patient's autonomy and preferences.

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: The correct answer is C because following up a few days after the interview shows professionalism and eagerness. It allows you to express gratitude, reiterate your interest, and inquire about the next steps. This timing is crucial as it keeps you fresh in the recruiter's mind without being too pushy. Choice A is incorrect because it is more appropriate to send a thank-you letter after the interview, not before. Choice B is incorrect as waiting 2 weeks after not getting the job may be too late for effective follow-up. Choice D is incorrect because you should not assume you got the position without confirmation.

Correct Answer: B

Rationale: The correct answer is B because an increase in patient census directly impacts the budget assumptions by affecting staffing needs, supply costs, and revenue projections. This information is crucial for accurate budget planning. Choice A is incorrect because the capital budget request for new equipment does not directly impact the nursing unit's operational budget assumptions. Choice C is incorrect as the effectiveness of participatory budgeting in controlling supply costs does not directly influence future budget assumptions. Choice D is incorrect as zero-based budgeting efficiency does not directly address the impact of increased patient census on budget assumptions.

Correct Answer: B

Rationale: The correct answer is B: Pilot. A pilot study involves testing a new intervention on a small scale to assess feasibility and potential outcomes before implementing it on a larger scale. In this case, the unit is planning to use an Electronic Medical Record for a limited time to evaluate its impact on documentation time and patient care. This approach allows for targeted feedback and adjustments based on the outcomes observed during the trial period. A: Ethnography involves in-depth observation and analysis of a specific culture or group, which is not the focus of the scenario. C: Secondary data analysis involves the use of existing data for research purposes, not the implementation of a new intervention. D: Phenomenology focuses on understanding individuals' subjective experiences, which is not the primary goal of implementing an Electronic Medical Record in this case.

Correct Answer: B

Rationale: The correct answer is B because quantifying the amount and intensity of care required is essential to determine staffing needs based on patient acuity. This involves assessing the complexity and severity of patients' conditions, which directly impacts the level of care needed. Patient satisfaction (A) does not provide objective data on acuity. Examining skill mix (C) is important but not the primary factor in determining acuity. Hospital days (D) reflect length of stay, not acuity level.

Correct Answer: A

Rationale: The correct answer is A: the registered nurse (RN). This task requires clinical judgment and critical thinking skills, which are within the scope of practice of an RN. The RN is trained to assess the patient comprehensively, identify potential risks, and communicate effectively with other healthcare team members. LPNs/LVNs may not have the same level of assessment skills as RNs. UAPs do not have the clinical knowledge or skills required for this task. Option D is incorrect as completing and signing the initial assessment requires active patient assessment, which is a dynamic process and not just about past information.

Correct Answer: C

Rationale: The correct answer is C: Connection. The nurse's power comes from her ability to network and build relationships with influential individuals like the Chief of Medical Staff and the President of the hospital. This grants her access to information, resources, and opportunities not available to others. This power is based on who she knows rather than her expertise (A), position (B), or ability to offer rewards (D). The nurse's statement implies that her influence stems from her connections, making choice C the most appropriate answer.