Nursing Elites

1. 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.

2. A healthcare professional walks into the nurse's station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions should the healthcare professional take first?

• A. remind the staff members that this is a breach of confidentiality
• B. discuss the issue with the unit manager
• C. request that an administrative restriction be placed on the client's medical access
• D. prepare a report for the facility ethics committee

Correct answer: A

Rationale: The correct action for the healthcare professional to take first is to remind the staff members that accessing the electronic medical record of a celebrity client from another unit is a breach of confidentiality. This immediate action addresses the ethical and legal issue at hand, emphasizing the importance of patient confidentiality and privacy. Discussing the issue with the unit manager, requesting administrative restrictions, or preparing a report for the facility ethics committee can be considered after addressing the initial breach and reminding staff members of their obligations.

3. What theme of critical thinking is demonstrated by the belief that continuous learning contributes to the ongoing process?

• A. Critical thinking is a productive and positive activity.
• B. Critical thinking is a process, not an outcome.
• C. Manifestations of critical thinking vary, depending on the context in which they occur.
• D. Critical thinking is triggered by both positive and negative events.

Correct answer: B

Rationale: The belief that continuous learning contributes to the ongoing process aligns with the theme that critical thinking is a process, not an outcome. This suggests that critical thinking involves a continuous, dynamic process of evaluating information, making connections, and adapting one's thinking over time, rather than being a fixed end result. Therefore, choice B is the correct answer. Choices A, C, and D do not directly address the continuous nature of critical thinking or its ongoing development, making them incorrect.

4. In a system of care delivery in which RNs, LPNs, and unlicensed assistive personnel implement specific tasks like medication administration or personal hygiene for the entire nursing unit, what term describes this type of delivery system?

• A. Primary nursing
• B. Team nursing
• C. Functional nursing
• D. Total patient care

Correct answer: C

Rationale: Functional nursing is a care delivery model where tasks are divided among team members based on their respective roles. In this system, RNs, LPNs, and unlicensed assistive personnel are assigned specific tasks to carry out for the entire nursing unit, such as medication administration or personal hygiene duties. The other choices are incorrect: A) Primary nursing involves one nurse being responsible for all aspects of care for a group of patients, B) Team nursing involves a team of healthcare providers working together to provide care for a group of patients, and D) Total patient care refers to one nurse being responsible for all aspects of care for one patient.

5. What factor has had the greatest impact on the current nursing shortage?

• A. Later age at which women have children
• B. Decrease in the number of women being born
• C. Overall unemployment rate
• D. Increased employment options for women

Correct answer: D

Rationale: The correct answer is D. The increased employment options for women have had a significant impact on the current nursing shortage. With more career choices available to women, there is a decrease in the number of individuals pursuing nursing as a profession, contributing to the shortage. This is because women are choosing diverse career paths due to increased opportunities. Choices A, B, and C are incorrect. A later age at which women have children and the decrease in the number of women being born are not directly related to the nursing shortage. The overall unemployment rate, while influencing job availability, is not the primary factor driving the shortage of nurses.

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