Nursing Elites

1. Which patient would be appropriately transferred to an assisted living facility?

• A. The patient requiring ongoing skilled nursing observation
• B. The patient who has recovered enough to return to work and daily life
• C. The child who was burned in a fire after losing both parents to the tragedy
• D. The patient who needs minimal assistance in performing activities of daily living but cannot live alone

Correct answer: D

Rationale: The correct answer is D. Patients suitable for transfer to assisted living facilities are those who require minimal assistance with activities of daily living but do not need constant skilled nursing observation. Option D aligns with the purpose of an assisted living facility, which provides support for individuals who can no longer live independently but do not require intensive medical care. Choices A, B, and C are incorrect because patients requiring ongoing skilled nursing observation, those who have recovered enough to return to work and daily life, and children who have experienced a traumatic event such as a fire are not typically candidates for assisted living facilities.

2. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

3. How does the high degree of professionalism among nurses impact their willingness to engage in organized strikes?

• A. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession
• B. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization
• C. Nurses who strike can be legally punished for abandonment and negligence considered to be professional misconduct
• D. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client's safety initiatives

Correct answer: A

Rationale: The correct answer is A. The high level of professionalism among nurses, as recognized in Gallup polls, often leads them to perceive organized strikes as conflicting with their duty to care for patients and uphold their professional standards. This conflict of interest can cause nurses to be hesitant or reluctant to participate in strikes. Choice B is incorrect because nurses' decision to engage in strikes is more influenced by professional values and patient care rather than evidence-based studies on management and labor views. Choice C is incorrect because while legal consequences may be a concern, the primary factor influencing nurses' decision on strikes is their professional commitment to patient care. Choice D is incorrect as nurses' focus during strikes is more on advocating for patient safety rather than emphasizing safety initiatives.

4. When teaching about community preparedness for a community group, the nurse should explain that the components of the national disaster medical system (NDMS) provide assistance in what form?

• A. making available a nationwide bomb disposal squad team for the rapid removal of explosive devices
• B. Facilitating patient evacuation from the disaster area to a non-affected area
• C. organizing ground for detonation of bombs by bomb squad
• D. providing mental health care for victims and healthcare providers in the community

Correct answer: B

Rationale: The correct answers are B and C. The NDMS is designed to provide medical response during disasters, assist in patient movement, and offer definitive care to disaster victims. This includes organizing teams of healthcare providers with specialized skills and equipment to respond effectively to emergencies. Patient evacuation from disaster areas to safer locations is also a key function of the NDMS to ensure the well-being of those affected by the disaster. Options A and D are incorrect because the NDMS does not provide bomb disposal services and is primarily focused on medical response rather than mental health care.

5. 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.

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