Free Nursing Leadership and Management practice for ATI Leadership Practice A (ATI RN). Answer 45 nursing exam-style questions with rationales, exam mode, and p
A nurse manager wants to implement a new policy on the unit. What is the first step in the change process according to Lewin's Change Theory?
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Explanation:
The correct answer is A: 'Unfreeze the system.' According to Lewin's Change Theory, unfreezing the system is the initial step in the change process. This step involves preparing the organization for change by creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Choice B, 'Move the system to a new level,' is incorrect as it does not align with the first step of unfreezing. Choice C, 'Refreeze the system,' is incorrect as it pertains to the final stage of solidifying the change, not the first step. Choice D, 'Evaluate the system,' is incorrect as evaluation typically occurs after the change has been implemented, not at the beginning of the change process.
The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?
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Explanation:
The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.
An expensive variable in salary budgets is overtime pay. Which of the following is a viable option to reduce overtime?
Select the best answer.
Explanation:
The correct answer is C: Using per diem workers. By utilizing per diem workers, organizations can flexibly adjust staffing levels based on demand without incurring overtime costs. This approach helps in managing overtime budgets effectively. Choice A is incorrect because limiting overtime for highly paid workers may not address the root cause of overtime expenses. Choice B is incorrect as reducing the number of beds does not directly impact overtime costs. Choice D is not a practical solution as refusing to pay overtime can lead to legal issues and employee dissatisfaction.
The belief that effort will lead to a specific performance level in an individual is known as:
Select the best answer.
Explanation:
The correct answer is B: Expectancy. Expectancy refers to the perceived probability that effort will lead to a specific performance level. This aligns with the concept of expectancy theory in psychology, which emphasizes the importance of individuals' beliefs regarding the link between effort and outcomes. Choices A, C, and D are incorrect. Rewards (choice A) typically refer to incentives given after achieving a goal, valence (choice C) is the value a person places on a particular outcome, and instrumentality (choice D) is the belief that a particular outcome is contingent on achieving a specific level of performance.
What is the primary focus of health promotion activities?
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Explanation:
The correct answer is C: 'To prevent the onset of disease.' Health promotion activities aim to prevent diseases before they occur by promoting healthy behaviors, lifestyles, and environments. Choice A, 'To manage chronic diseases,' is incorrect as health promotion focuses on prevention rather than management. Choice B, 'To educate patients about their health,' is important but not the primary focus of health promotion. Choice D, 'To identify and treat diseases early,' is related to early detection and treatment, which is different from the primary goal of health promotion.
A registered nurse (RN) administered a patient’s morning insulin as the breakfast tray arrived at 0800. The RN performed a complete assessment at the same time. Then, the RN got busy with her other patients and did not check on the patient until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. Which of the following could the RN be charged with?
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Explanation:
Negligence is the failure to act in a reasonable, ordinary, and prudent manner, causing harm to someone who is owed the duty to care.
Which statement to a patient newly diagnosed with type 2 diabetes is correct?
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Explanation:
Choice C is the correct statement to convey to a patient newly diagnosed with type 2 diabetes. Lifestyle modifications, such as changes in diet and exercise, are essential components of managing type 2 diabetes. These changes can help control blood glucose levels and improve overall health. Options A, B, and D are incorrect statements. While complications of type 2 diabetes can be serious, they are different from those of type 1 diabetes. Some patients with type 2 diabetes may require insulin therapy, but it is not true that insulin is not used at all. Type 2 diabetes is not typically diagnosed during a hyperglycemic coma, as it is usually identified through routine screenings or symptoms unrelated to a coma.
The charge nurse role has negatively affected your relationship with your friends and made you feel tense and isolated. You decide that you will delegate more time-consuming tasks to staff who are not your friends, who then complain to your nurse manager about your perceived unfairness. You decide to:
Select the best answer.
Explanation:
In this scenario, it is essential to address the perceived unfairness in task delegation. Talking with your friends individually to explain that patients will be assigned equitably is the most appropriate course of action. This approach promotes transparency and fairness in task allocation, helping to maintain professional relationships. Choices B, C, and D are not suitable responses. Choice B ignores the issue, choice C involves unprofessional behavior by gossiping about colleagues, and choice D neglects addressing the root cause of the problem.
Recent polls have placed nursing as one of the most trusted professions because of which of the following?
Select the best answer.
Explanation:
Recent polls have identified nursing as one of the most trusted professions due to nurses possessing the necessary skills to provide care for diverse populations. This includes understanding and addressing the unique needs of individuals from various backgrounds and cultures. Choice A is incorrect because while nurses do engage in lifelong learning, this is not the primary reason for their trustworthiness. Choice B is also incorrect as abiding by a dress code does not directly contribute to the trust placed in nurses. Choice D is incorrect because passing the NCLEX exam is a regulatory requirement for obtaining a license and does not solely determine the trustworthiness of nurses in the eyes of the public.
Professionalism has historically been difficult to define. Early definitions of professionalism included which of the following characteristics?
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Explanation:
The correct answer is A: 'Expertise.' Historically, professionalism was defined by one's knowledge and expertise in a particular field. Choices B, C, and D are incorrect because early definitions of professionalism did not focus on qualities like empathy, ethical and moral values, or honesty, but rather on the individual's level of skill and competence in their area of work.
Which of the following best describes the ethical concept of values?
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Explanation:
Values are how individuals feel about ideas, situations, and concepts.
Nonverbal messages in communication, including body language and environmental factors, are called ___________.
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Explanation:
Nonverbal messages in communication, such as body language and environmental factors, are termed metacommunications. Choice A, lateral communication, refers to communication between individuals or groups on the same hierarchical level. Choice B, upward communication, involves the flow of information from lower levels to higher levels in an organization. Choice D, downward communication, relates to the transmission of information from higher levels to lower levels within an organization. Therefore, the correct term for nonverbal messages in communication is metacommunications.
What is the role of a nurse in a multidisciplinary team (MDT)?
Select the best answer.
Explanation:
In a multidisciplinary team (MDT), a nurse's role is to advocate for patient needs and ensure their perspectives are considered in the care plan. While leadership may be a part of a nurse's role in some settings, the primary focus in an MDT is collaboration and coordination. Providing emotional support is essential but may not be the primary role of a nurse in an MDT. Conducting clinical research is typically not a direct responsibility of a nurse in an MDT focused on patient care.
There are several pitfalls that should be avoided when using social media of any type. For example, a nurse or student could be found guilty of libel in which of the following scenarios?
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Explanation:
Complaining about her nurse preceptor on social media, discussing the preceptor’s unprofessional characteristics, could be considered libel.
Which action by a patient indicates that the home health nurse’s teaching about glargine and regular insulin has been successful?
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Explanation:
What is the primary purpose of clinical pathways in healthcare?
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Explanation:
The primary purpose of clinical pathways in healthcare is to provide individualized care. While clinical pathways do involve standardizing treatment plans, their main goal is to tailor these plans to the individual needs of patients. This customization ensures that patients receive care that is specific to their condition and requirements, rather than a one-size-fits-all approach. Choices A, B, and D are incorrect because although reducing hospital readmissions, standardizing care, and streamlining care processes can be benefits of clinical pathways, they are not the primary purpose. The main focus is on delivering personalized treatment paths to enhance patient outcomes.
After the nurse has finished teaching a patient who has a new prescription for exenatide (Byetta), which patient statement indicates that the teaching has been effective?
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Explanation:
A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?
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Explanation:
The correct answer is D: Decrease in capillary refill time. In a client with fluid volume deficit, improving capillary refill time indicates that the perfusion status is improving due to the increase in fluid volume. Choices A, B, and C are incorrect. An increase in hematocrit may indicate hemoconcentration due to fluid loss, an increase in respiratory rate may suggest respiratory distress, and a decrease in heart rate may not be directly related to fluid volume status.
One way to determine staffing needs is to classify clients according to nursing care required. Another name for this is a(n) __________.
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Explanation:
The correct answer is D: acuity system. An acuity system involves classifying clients based on the nursing care they require to determine staffing needs accurately. Choice A, self-scheduling, is not related to classifying clients based on care needs. Choice B, supplementing staff system, does not specifically refer to the classification of clients. Choice C, patient classification system (PCS), is close but not as commonly used as 'acuity system' in healthcare settings to determine staffing needs.
What quality is observed among individuals who strive to find the best way to do their job?
Select the best answer.
Explanation:
Motivation is the driving force that compels individuals to strive to find the best way to do their job. It encompasses determination, enthusiasm, and a proactive approach to continuously improve and excel in their work. Being motivated is essential for individuals in any profession to seek innovative solutions, achieve excellence, and make a meaningful impact. Punctuality, while important, refers to being on time rather than the drive to find the best way to do a job. Strictness relates to enforcing rules or discipline, not necessarily to seeking the best way. Honesty is about truthfulness and integrity, which are crucial but not directly related to the pursuit of excellence in job performance.
When in opposition to an immediate superior, a nurse manager should use which important strategy in a confrontation?
Select the best answer.
Explanation:
When in a confrontation, using 'I' language is crucial for a nurse manager. This approach allows the manager to express personal feelings without sounding accusatory, which can help reduce defensiveness and promote open communication. Choices B, C, and D are incorrect. Using absolutes can come off as rigid and may escalate the conflict. 'Why' questions can be perceived as confrontational and may put the other person on the defensive. Negative assertions can lead to a more hostile exchange rather than fostering a constructive dialogue.
A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses?
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Explanation:
Moral suffering occurs when a situation results in a feeling of uneasiness or concern because of behaviors or circumstances that challenge one’s own morals and beliefs.
Which of the following best describes the concept of shared governance?
Select the best answer.
Explanation:
The correct answer is C: 'Shared decision making.' Shared governance in healthcare involves empowering nurses to participate in decision-making processes that affect their practice. This model fosters collaboration, transparency, and accountability among healthcare providers. Choice A, 'Top-down management,' is incorrect because shared governance promotes a bottom-up approach. Choice B, 'Nurse-led committees,' is partially correct as it is a component of shared governance, but the core concept is broader and encompasses shared decision making beyond committee leadership. Choice D, 'Hierarchical structure,' is incorrect as shared governance aims to flatten hierarchies and distribute decision-making authority among healthcare team members.
The problem of overrating staff performance is called ___________ .
Select the best answer.
Explanation:
The correct answer is D, 'Leniency error.' Leniency error occurs when a manager tends to overrate staff performance, giving higher ratings than deserved. Choice A, 'Recency error,' refers to the tendency to focus only on recent behaviors or events when evaluating performance. Choice B, 'Absolute judgment,' is not directly related to overrating staff performance; it refers to making evaluations without considering the context or comparison points. Choice C, 'Halo error,' involves allowing one positive aspect of an individual to overshadow other factors in performance evaluation, which is different from overrating overall staff performance.
A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?
Select the best answer.
Explanation:
The correct answer is B. Amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, which helps in reducing the transmission of pain impulses to the brain. Choice A is incorrect because amitriptyline primarily works on pain transmission rather than directly on depression. Choice C is inaccurate as amitriptyline's mechanism of action is not related to correcting blood vessel changes. Choice D is partially true as amitriptyline can improve sleep, but the primary mechanism related to pain relief is by preventing pain impulses from reaching the brain.
While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.
Select the best answer.
Explanation:
The correct answer is B: Functional. In functional structures, employees are grouped into departments based on specialty, allowing individuals with similar skills and tasks to work together efficiently. In this scenario, organizing the hospital into departments such as nursing, dietary, and pharmacy based on their specialties exemplifies a functional organizational structure. Choice A, Parallel structure, involves independent units working on similar tasks, which is not the case here. Choice C, Service-integrated structure, emphasizes cross-functional teamwork across various departments, which is not the main focus in the scenario. Choice D, Matrix structure, involves employees reporting to multiple managers for different projects or tasks, which is not described in the scenario.
A client is discussing the use of herbal supplements for health promotion with a nurse. Which of the following client statements indicates an understanding of herbal supplement use?
Select the best answer.
Explanation:
The correct answer is D. Ginkgo biloba is commonly used to improve blood circulation and relieve symptoms of cognitive disorders like dementia. The other choices are incorrect because echinacea is used to boost the immune system, feverfew is used for migraines and headaches, and ginger is known for its anti-inflammatory properties and aiding digestion, not memory improvement.
Achieving Magnet Hospital designation offers hospitals the following advantages: (Select all that apply.)
Select the best answer.
Explanation:
Achieving Magnet Hospital designation offers hospitals advantages such as improved nursing recruitment and greater nursing retention. The empowered, independent problem-solving nurses resulting from this designation contribute to greater client satisfaction and improved nursing care. Therefore, the correct answer is 'Greater client workload' (C). Choices A, B, and D are incorrect because although they are beneficial outcomes of achieving Magnet Hospital designation, they are not advantages specifically mentioned in the provided rationale.
Which of the following are essential components of strategic planning?
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Explanation:
In strategic planning, values and vision and mission statements play crucial roles. Values guide the organization's culture and decision-making processes, while vision and mission statements outline its long-term goals and purpose. Reengineering, on the other hand, is a separate process focused on restructuring business processes for improved performance efficiency. Therefore, the correct components of strategic planning are values and vision and mission statements, making option D the correct answer. Choices A and B are correct because they are directly related to setting the direction and purpose of the organization in a strategic planning process, while choice C, reengineering, is not typically considered a core element of strategic planning.
Which of the following is a key principle of team nursing?
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Explanation:
The correct answer is D: 'Shared responsibility.' Team nursing emphasizes shared responsibility among team members for patient care. This approach promotes collaboration and coordination among healthcare professionals to deliver comprehensive and holistic care. Choices A and B are incorrect because team nursing typically involves collaborative decision-making rather than centralized or decentralized decision-making. Choice C, 'Individual accountability,' does not align with the collaborative nature of team nursing, where responsibility is shared among team members rather than falling solely on individuals.
A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?
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Explanation:
Satisficing is the correct decision-making strategy in this scenario. The nurse manager is not aiming for the best solution but rather choosing an alternative that is good enough given the circumstances of staff shortage. Choice B, Routine, does not apply here as the situation is not part of the manager's regular tasks. Choice C, Adaptive, involves adjusting to new conditions, which is not the primary focus in this scenario. Choice D, Rationalizing, does not fit as the decision made is more about finding an acceptable solution rather than justifying it.
What is the main purpose of health informatics?
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Explanation:
The main purpose of health informatics is to enhance clinical decision making. While managing patient care (choice A) and storing patient records (choice B) are important functions within health informatics, the primary goal is to improve decision making processes by utilizing technology and data. Improving healthcare policies (choice D) is not the main purpose of health informatics, although it can be a byproduct of better-informed decision making.
Which of the following is one of the positive benefits of conflict within an organization?
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Explanation:
The correct answer is C. Conflict within an organization can help people recognize legitimate differences and motivate them towards improved performance. This recognition of differences can lead to constructive discussions and solutions. Choice A is incorrect because conflict does not necessarily always lead to compromising values and beliefs. Choice B is incorrect as conflict should not be about fostering intergroup competition but rather about addressing and resolving issues. Choice D is incorrect as conflicts do not always result in a win-win resolution; sometimes, compromises or trade-offs are necessary for resolution.
Which of the following best defines the role of a nurse practitioner (NP)?
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Explanation:
The correct answer is B: 'Diagnose and treat medical conditions independently.' Nurse practitioners (NPs) are advanced practice registered nurses who are qualified to diagnose and treat medical conditions without direct supervision from a physician. Choice A is incorrect because NPs have the autonomy to provide care independently. Choice C is incorrect as NPs focus on clinical care rather than administrative tasks. Choice D is incorrect as specializing in a specific area of nursing practice refers to a different aspect of advanced nursing roles, such as becoming a clinical nurse specialist.
When a Nurse Manager leaves the facility, and one of the remaining managers is given that assignment in addition to her current load without the open position being filled, this is an example of which of the following?
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Explanation:
The correct answer is A, job enlargement. Job enlargement involves adding more tasks to a job without changing the level of skill required. In this scenario, the manager is given additional responsibilities without the position being filled, resulting in combining positions and increasing the number of employees to supervise. Choice B, proactive management, is incorrect as it does not relate to the situation described. Choice C, time log, is not relevant to the scenario. Choice D, prioritizing, is also incorrect as it does not reflect the concept of combining positions and increasing supervisory responsibilities.
Which of the following is likely to facilitate union activity?
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Explanation:
The correct answer is C because according to a study by Bilchik (2000), organizations are more likely to unionize if there is a belief that low wages cause job dissatisfaction. Choices A and B focus on effective communication and listening, which may actually prevent union activity by addressing employee concerns directly. Choice D, the belief that supervisors are not understanding of unionizing, may lead to dissatisfaction but doesn't directly facilitate union activity as the belief that low wages cause job dissatisfaction does.
A nurse manager asks the staff to submit written suggestions for a change in policy. The group would then vote on the different suggestions. What type of decision-making technique did the nurse manager use?
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Explanation:
The nurse manager used the nominal group technique. This technique involves group members submitting written suggestions, followed by a voting process. Statistical aggregation involves analyzing numerical data, not suggestions. Brainstorming focuses on generating creative ideas collectively, without a structured voting process. Delphi technique involves reaching a consensus through a series of questionnaires or surveys, without a direct voting process.
Although technology has seen many advances, which two ethical principles may be in conflict because of technology?
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Explanation:
The correct answer is B: Beneficence and nonmaleficence. Beneficence is the ethical principle of doing good to benefit others, while nonmaleficence is the principle of doing no harm to others. With technological advances, there can be a conflict between these two principles, as the benefits of technology may inadvertently cause harm, leading to an ethical dilemma. Choices A, C, and D are incorrect because while beneficence is involved in all options, the conflicting principle of nonmaleficence specifically addresses the avoidance of harm, making it the most relevant in the context of technology's impact on ethical principles.
In determining a way to make shift change more effective for the nurse and the client, a hospital implemented a course of action. After a week of implementation, the decision was deemed inappropriate. What step of Roger's diffusion of innovations is this?
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Explanation:
The correct answer is A: Confirmation. In the diffusion of innovations theory by Rogers, the confirmation stage seeks reinforcement of the action taken. In this scenario, after implementing the course of action regarding shift changes, the decision was reviewed and found inappropriate, aligning with the confirmation phase. Choice B, 'Implementation,' refers to putting the plan into action, which had already been done. Choice C, 'Knowledge,' pertains to becoming aware of the innovation, not evaluating its effectiveness. Choice D, 'Persuasion,' involves efforts to influence individuals to adopt the innovation, not verifying its appropriateness.
In a multiple-car accident with multiple trauma clients being sent to an Emergency Department, which type of leadership would be most effective in this situation?
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Explanation:
In a high-stress situation like a multiple-car accident with multiple trauma clients arriving at the Emergency Department, autocratic leadership is most effective. This type of leadership allows for clear direction and quick decision-making, crucial in managing emergencies. Democratic leadership may slow down the decision-making process due to the need for consensus. Bureaucratic leadership focuses on following established rules and procedures, which may not be flexible enough in an emergency. Laissez-faire leadership, characterized by a hands-off approach, is not suitable in urgent situations where immediate action is required.
Which leadership style is most effective in a crisis situation?
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Explanation:
An autocratic leadership style is most effective in a crisis situation because it allows for quick decision-making without the need for extensive consultation or deliberation. In a crisis, immediate and decisive actions are often required to address the situation effectively. Democratic leadership, on the other hand, may slow down the decision-making process due to the need for consensus and input from team members. Transformational leadership focuses on inspiring and motivating followers, which may not always be as effective in a crisis where urgent actions are needed. Laissez-faire leadership, characterized by a hands-off approach, is generally ineffective in crisis situations as it lacks the necessary direction and guidance required to navigate through the challenges efficiently.
Which of the following is an example of a primary prevention strategy?
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Explanation:
Administering vaccinations is indeed an example of a primary prevention strategy. Primary prevention aims to prevent the occurrence of a disease or injury before it occurs by targeting the entire population or specific high-risk groups. Vaccinations help prevent the initial development of a disease by enhancing immunity against specific pathogens. Choices B, C, and D are not examples of primary prevention strategies. Performing a surgical procedure (Choice B) is a treatment intervention, not a preventive measure. Teaching healthy lifestyle choices (Choice C) falls under health promotion and education, which is more aligned with secondary prevention. Prescribing medication (Choice D) is typically associated with treatment rather than preventing the initial onset of a disease.
Which of the following describes the ability to enter into a contract with an employer?
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Explanation:
The correct answer is A, 'Certification to contract,' which refers to the process by which a union, certified by the NLRB as a bargaining agent, can enter into a contract with an employer that has been voted on by the union membership. The other choices are incorrect because 'Certification to represent' does not specifically address entering into a contract, 'Bargaining agreement' refers to the actual agreement reached through negotiation, and 'Contract agreement' is redundant, as it simply repeats the term 'contract.'
What is the role of the Joint Commission in healthcare?
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Explanation:
The correct answer is D: 'Approving healthcare facilities.' The Joint Commission's primary role is to accredit and certify healthcare organizations and programs in the United States. This accreditation ensures that healthcare facilities meet specific quality and safety standards. Choices A, B, and C are incorrect because the Joint Commission focuses on evaluating and accrediting healthcare facilities rather than advocating for patients, providing direct care, or setting standards for patient care.
An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN’s friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying?
Select the best answer.
Explanation:
The RN should consider the ethical principle of confidentiality when replying.
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