The nurse manager meets with upper management to share strategic goals agreed upon by her staff for their individual nursing unit as the first step to begin budget negotiations. One strategic goal is that staff will have access to technology that will allow them to incorporate point-of-care devices for all RNs. The second goal is to improve RNs' ability to recognize critical indicators that a patient's health status is deteriorating through advanced health assessment skills. During the meeting the manager discusses the strategy options and selecting the one that works for the unit. Which type of budget development is used?

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Contemporary Ethical Issues in Nursing Questions

Question 1 of 9

The nurse manager meets with upper management to share strategic goals agreed upon by her staff for their individual nursing unit as the first step to begin budget negotiations. One strategic goal is that staff will have access to technology that will allow them to incorporate point-of-care devices for all RNs. The second goal is to improve RNs' ability to recognize critical indicators that a patient's health status is deteriorating through advanced health assessment skills. During the meeting the manager discusses the strategy options and selecting the one that works for the unit. Which type of budget development is used?

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.

Question 2 of 9

The novice nurse arrives on the nursing unit, is introduced to the staff, is assigned a preceptor, and is asked to participate in the next staff meeting. This introduction into nursing is appropriately termed:

Correct Answer: B

Rationale: The correct answer is B: socialization. Socialization is the process by which individuals learn and adapt to the values, norms, and behaviors of a particular group, in this case, the nursing profession. In this scenario, the novice nurse is being introduced to the staff, assigned a preceptor, and asked to participate in a staff meeting, all of which are key components of the socialization process in nursing. A: Biculturalism refers to the coexistence of two distinct cultures within one society, which is not applicable in this context. C: Transition is the process of changing from one state to another, which is a broader concept than just the introduction to a new profession. D: "Going native" is a colloquial term that refers to adopting the lifestyle or customs of a foreign culture, which is not relevant to the scenario of a novice nurse being introduced to the nursing profession.

Question 3 of 9

A client is admitted with chest pain. A series of diagnostic tests are ordered, and the client undergoes coronary artery bypass grafting. The cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (ICU) stay by 3 days because of respiratory problems. The case manager realizes that under the terms of the diagnosis-related group (DRG) payment system for this diagnosis:

Correct Answer: B

Rationale: The correct answer is B. The DRG payment system is a fixed reimbursement amount for a specific diagnosis or procedure. In this case, the cost of care exceeded the DRG reimbursement amount due to the extended ICU stay caused by the client's smoking history. The hospital will only be reimbursed at the set fee specified by the DRG, regardless of the actual cost incurred. Choice A is incorrect because the hospital cannot collect additional fees from the insurance company beyond the DRG reimbursement amount. Choice C is incorrect as the client is not typically held responsible for the additional costs incurred. Choice D is incorrect because physician payment is not directly impacted by the hospital's financial losses. The DRG system focuses on fixed reimbursements based on diagnoses, not individual physician payments.

Question 4 of 9

A nurse is assigned to a unit where 95% of all patients required total care. Most days the assistive personnel are able to complete their assignments and provide high-quality care. A patient returning from a procedure was somehow "skipped" when daily baths were performed and requests that her care now be provided. The nurse discovers the bed is rumpled and damp. The RN joins with some other staff to bathe the patient, change the bed, and help make the patient comfortable. These staff members are demonstrating:

Correct Answer: A

Rationale: The correct answer is A: altruism. Altruism is the selfless concern for the wellbeing of others, which is demonstrated by the staff members helping the patient in need without hesitation. In this scenario, the staff members are putting the patient's needs above their own, showing compassion and empathy. This aligns with the principle of altruism in nursing, where caregivers prioritize the welfare of their patients. Choices B, C, and D are incorrect: B: Veracity refers to truthfulness and honesty. While these are important traits in nursing, they are not the focus of the staff members' actions in this scenario. C: Autonomy is the right of individuals to make decisions about their own care. In this situation, the patient is not exercising autonomy, but rather relying on the staff for assistance. D: Whistle-blowing involves reporting unethical or illegal behavior within an organization. There is no indication of any wrongdoing that would require whistle-blowing in this scenario.

Question 5 of 9

A nurse is preparing to teach a class related to risk factors for cancer to a diverse ethnic group attending a health fair. The nurse should be aware:

Correct Answer: C

Rationale: The correct answer is C because it provides accurate information about a specific risk factor related to a particular ethnic group. American-Indian women do have a higher rate of ovarian cancer than the general population, making it crucial for the nurse to be aware of this when teaching about cancer risk factors. A is incorrect as it discusses breast cancer and not ovarian cancer. B is incorrect as it mentions esophageal cancer, which is not the specific focus of the question. D is also incorrect as it makes a general statement about cancer, heart disease, and stroke in ethnic groups without providing specific information about ovarian cancer in American-Indian women.

Question 6 of 9

What is the initial step when addressing an ethically challenging situation?

Correct Answer: B

Rationale: The correct answer is B: Review the overall situation to identify the core issues. This is the initial step when addressing an ethically challenging situation because it allows you to gain a comprehensive understanding of the situation before delving into specific details. By reviewing the overall situation, you can identify the key ethical issues at play and prioritize which aspects need to be addressed first. This step sets the foundation for developing an effective strategy to navigate the ethical dilemma. Incorrect answers: A: Identifying all those involved is important, but it should come after reviewing the situation. C: Gathering facts is necessary, but reviewing the overall situation should precede this step. D: Determining the ethical dilemma is crucial, but it is more effective to first review the entire situation to fully grasp the complexities before pinpointing the ethical issue.

Question 7 of 9

Although the NCLEX-RN examination has new formats for questions, the most common format is the:

Correct Answer: B

Rationale: The correct answer is B: multiple-choice question item, which allows candidates to select the one correct answer. This is because the multiple-choice format is widely used in the NCLEX-RN examination as it is effective in assessing a candidate's knowledge, critical thinking skills, and ability to make decisions. The distractors in the answer choices provide clues and test the candidate's ability to differentiate between correct and incorrect information. Choices A, C, and D are incorrect: A: fill-in-the-blank item is not the most common format for NCLEX-RN questions as candidates are indeed provided with clues from distractors in multiple-choice questions. C: multiple-response item, although requiring critical thinking, is not the most common format on the NCLEX-RN exam. D: hot-spot item is not the most common format on the NCLEX-RN exam, and it is not necessarily written at the application level of Bloom's analysis.

Question 8 of 9

Nurses caring for the victims of a mass casualty incident:

Correct Answer: D

Rationale: The correct answer is D because prioritizing care based on the greatest chance of survival maximizes the number of lives saved in a mass casualty incident. This approach follows the principle of triage, which aims to allocate resources efficiently. Choice A is incorrect as it pertains to coordination rather than immediate patient care. Choice B is incorrect as it is not the primary role of nurses during a mass casualty incident. Choice C is incorrect as determining a credible threat is the responsibility of security and law enforcement, not nurses.

Question 9 of 9

A client states, "I am leaving. No one here knows what they are doing." The nurse completing the Against Medical Advice form must:

Correct Answer: C

Rationale: Rationale: Choice C is correct because informing the client of potential complications and impairment is essential to ensure the client makes an informed decision. This aligns with the principle of autonomy and informed consent. Choice A is incorrect as delaying notification can jeopardize the client's safety. Choice B is incorrect because using medical jargon may not effectively communicate the risks to the client. Choice D is incorrect as using restraints is a violation of the client's rights and autonomy.

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