Nursing Elites

1. How do accrediting agencies such as the Joint Commission ensure quality care?

• A. Imposing maximum staffing levels
• B. Stipulating nurse-patient ratios
• C. Confirming delivery of satisfactory care
• D. Requiring a specific staff mix

Correct answer: C

Rationale: Accrediting agencies such as the Joint Commission primarily focus on confirming the delivery of satisfactory care rather than imposing specific staffing levels, nurse-patient ratios, or staff mix. They do not dictate the exact staffing levels or ratios but rather evaluate if the care provided meets established quality standards. While adequate staffing levels and appropriate nurse-patient ratios are essential for quality care, accrediting agencies like the Joint Commission assess the outcomes and overall quality of care delivered by healthcare facilities.

2. In a unionized hospital, nurses receive compensatory pay for working holidays based on the hours worked with no extra compensation. Despite management refusing to consider changes to the compensatory pay system suggested by nurses during the annual employee satisfaction survey, a trend member listened to both parties and made non-legally binding recommendations. What is this type of settlement known as?

• A. Collective bargaining
• B. Mediation
• C. Grievance
• D. Binding arbitration

Correct answer: B

Rationale: Mediation involves a neutral third party who assists in resolving disputes by providing non-legally binding recommendations. In this scenario, the trend member acted as a mediator by listening to both nurses and management and offering suggestions without the authority to enforce them as a legally binding decision. Collective bargaining refers to negotiations between labor unions and employers to determine terms of employment. Grievance is a formal complaint by an employee against an employer. Binding arbitration involves a neutral third party making a final and legally binding decision to resolve a dispute.

3. Which role is not appropriate for the LPN to participate in?

• A. Administering medications
• B. Dressing changes
• C. Designing a research study
• D. Reporting patient changes

Correct answer: C

Rationale: The correct answer is C. Designing a research study is not typically within the scope of practice for a Licensed Practical Nurse (LPN). LPNs are primarily involved in providing direct patient care, such as administering medications, performing dressing changes, and reporting patient changes. Designing research studies usually requires advanced education and training beyond what an LPN receives, making it an inappropriate role for an LPN to participate in.

4. How can a student best prepare for a clinical experience?

• A. Practice and review procedures for performing skills
• B. Review class notes from the past week
• C. Familiarize oneself with the clinical facility
• D. Arrive at the clinical site 1 hour early

Correct answer: A

Rationale: Practicing and reviewing procedures for performing skills is crucial for a student preparing for a clinical experience. This preparation allows the student to build competence and confidence in executing required tasks. Reviewing class notes may be helpful for theoretical knowledge but may not adequately prepare the student for practical skills needed in a clinical setting. Familiarizing oneself with the clinical facility is beneficial but does not directly address skill readiness. Arriving early is important but does not substitute for the essential preparation of practicing and reviewing procedures for performing skills.

5. What is the difference between mediation and binding arbitration based on the statement provided?

• A. Mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor
• B. Mediation uses a trained person to facilitate negotiations without making a final decision
• C. Binding arbitration is a formal process where an arbitrator's decision is final and must be adhered to by both parties
• D. Binding arbitration requires both labor and management to engage in discussions to find the least harmful resolution

Correct answer: C

Rationale: The key difference between mediation and binding arbitration lies in the finality of the decision. In binding arbitration, the arbitrator's decision is ultimate, and both parties are obligated to comply with it. This differs from mediation, where a neutral third party facilitates negotiations but does not make a final decision. Choice A is incorrect as mediation is not necessarily sanctioned by the NLRB; it can be conducted independently. Choice B is incorrect because mediation does not involve a final decision-maker but focuses on facilitating discussions. Choice D is incorrect as binding arbitration does not aim to find the least harmful resolution but rather a final and binding decision by the arbitrator.

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