Nurse Executive Practice Questions

1. Paternalistic actions are incompatible with nursing ethics because they:

  1. reduce ethical obligation.
  2. reduce the accountability of the nurse.
  3. decrease the authority of the nurse.
  4. diminish the autonomy of the patient.

2. The nursing care delivery model in which a nurse holds 24-hour responsibility for a patient from admission through discharge is known as:

  1. team nursing.
  2. modular nursing
  3. functional nursing.
  4. primary nursing.

3. A patient classification system is used to measure:

  1. customer satisfaction.
  2. acuity level.
  3. performance variations.
  4. patient safety.

4. The original purpose for the development of diagnosis-related groups was to:

  1. determine Medicare reimbursement at a fixed-fee.
  2. provide funding for private insurance companies.
  3. determine prescription drug benefits.
  4. provide sliding-scale reimbursement for Medicare beneficiaries.

5. Medical waste disposal programs are primarily regulated at the:

  1. federal level.
  2. local level.
  3. state level.
  4. community level.

Answers and Explanations

  1. D: Paternalistic actions and attitudes diminish the patient's autonomy. Paternalism relates to using one's own judgment to make decisions for another without considering their ideas. In this context, the principles of autonomy and beneficence are in conflict and create an ethical challenge. While respect for the autonomy of the patient should be observed, nurses and other health care providers must implement sound judgment under the principle of beneficence. To meet this challenge, nurses must recognize the importance of personal choice and equality in a professional nurse-patient relationship.
  2. D: The framework of how nursing care is delivered in an organization is called a nursing care delivery model. There are four classic models; total patient care, functional nursing, team nursing, and primary nursing. In the total patient care model, a patient receives complete care by one nurse for an entire shift. In a functional nursing model, tasks are divided for groups of patients. The registered nurse (RN) performs advanced nursing functions for a group of patients, and other tasks, such as personal care and vital signs, may be assigned to ancillary staff members. In team nursing, an RN team leader manages care for a small group of patients by planning and delegating tasks to team members. Primary nursing is different from the total patient care model in that the RN holds 24-hour responsibility for the communication and direction of each patient's care, although some patient care may be delegated to support staff.
  3. B: Nurse Executives play a key role in the development of effective patient classification systems (PCS). A PCS is used to measure the level and amount of care or the acuity level for specific populations of patients. Examples include medical, pediatric, ambulatory, and psychiatric classification systems. One of the main goals in the development of a PCS is ensuring the delivery of safe care by providing appropriate staffing levels with competent personnel to care for patients from a specific population. Other goals include maintaining customer and staff satisfaction while adhering to financial resources.
  4. A: In 1983, the Social Security Act was amended to include a prospective payment system for Medicare beneficiaries. Diagnosis-related groups (DRGs) were originally designed as part of a classification system used by Medicare to determine reimbursement at a fixed-fee. DRGs are based on several factors, including the International Classification of Disease diagnoses, procedures, age, and the presence of comorbidities. Since the amendment, health care has evolved, leading to specialized types of DRGs, such as All Patient DRGs and Refined DRGs.
  5. A: The Environmental Protection Agency (EPA) implements laws by writing regulations and setting national standards that protect human health and the environment. The EPA regulates hazardous waste at the federal level and provides model guidelines for state medical waste management programs. Biomedical waste programs and disposal are primarily regulated at the state level. Laws vary depending on state. The web site, www.epa.gov, can be visited for additional information.

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Last Updated: 12/19/2017


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