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. Where do many people get medical insurance from?

• A. The primary care physician
• B. The local clinic
• C. Social security office
• D. The employer

Correct answer: D

Rationale: Many people obtain medical insurance through their employer. This is a common practice where employers offer health insurance benefits to their employees as part of their employment package. Choice A, primary care physician, is incorrect as they provide medical care, not insurance. Choice B, the local clinic, is incorrect as clinics offer medical services, not insurance. Choice C, social security office, is incorrect as it is not a typical source for obtaining medical insurance.

3. According to Watson's theory, how should the nurse manager deal with a staff member who has a substance addiction and is arriving at work under the influence of the substance?

• A. Send the nurse home with instructions not to return until clear of the substance.
• B. Call the police and have the nurse arrested for working while impaired.
• C. Confront the nurse privately, order drug testing, and suggest a substance abuse program.
• D. Notify the board of nursing and fire the nurse immediately.

Correct answer: C

Rationale: According to Watson's theory, a caring approach is essential. Confronting the nurse privately, ordering drug testing, and suggesting a substance abuse program demonstrates empathy and supports the staff member in seeking help for their addiction. This approach aligns with the principles of human caring and compassion, focusing on the well-being and recovery of the individual rather than punitive measures. Choices A and D are too harsh and lack empathy, not considering the individual's well-being or offering support for rehabilitation. Choice B is inappropriate and punitive, not aligned with a caring and compassionate approach as advocated by Watson's theory.

4. What motivates a nurse to perform tasks, whether at work or off duty?

• A. Personal motivation
• B. Facility policies
• C. Fear of reprisals
• D. Parental expectations

Correct answer: A

Rationale: Personal motivation is the driving force behind a nurse's actions, influencing their decisions and behaviors both during work hours and while off duty. It is an internal drive that compels them to act in a certain way, regardless of external factors such as facility policies, fear of reprisals, or parental expectations. While facility policies may guide their actions within the workplace, they do not address motivation. Fear of reprisals and parental expectations are external factors and are less likely to be the primary motivators for a nurse's actions.

5. On what basis does the U.S. healthcare system operate?

• A. Healthcare is a basic right provided to all equally.
• B. Ability to pay determines access to care.
• C. Only the rich are entitled to healthcare.
• D. Health insurance is required to obtain care.

Correct answer: B

Rationale: The correct answer is B. In the U.S., the healthcare system operates on a model where access to healthcare services is largely determined by an individual's ability to pay for care. This means that those with more financial resources have greater access to a wider range of healthcare services, while those with limited financial means may face barriers to accessing necessary care. Choices A, C, and D are incorrect because healthcare in the U.S. is not universally provided as a basic right to all equally, it is not exclusively for the rich, and while health insurance is common, it is not the sole determinant of access to care.

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