Ethics and Issues in Contemporary Nursing

Correct Answer: D

Rationale: The correct answer is D because developing a 5-year plan that incorporates the clinical nurse leader aligns with strategic planning, which involves setting long-term goals and outlining strategies to achieve them. This action demonstrates forward-thinking and aligns with the organization's overall vision. A: Ensuring nurses understand organizational philosophy is important but does not specifically relate to strategic planning. B: Evaluating communication processes is more operational or tactical in nature, not directly tied to long-term strategic planning. C: Monitoring data from a quality management initiative is important for quality improvement but does not directly relate to future planning and strategy development.

Correct Answer: A

Rationale: The correct answer is A because in a universal health care system, one universal payer (often the government) is responsible for covering all health care expenses for all citizens. This means that everyone, regardless of income or eligibility, is covered under the same system. Choice B is incorrect because a single-payer system does not necessarily limit health care access based on income; it simply means there is one entity responsible for paying health care costs. Choice C is incorrect because single-payer systems do not rely on insurance companies to pay fees; instead, the single payer itself covers the costs directly. Choice D is incorrect because it does not specify that the one payer in a universal health care system is usually the government, which is a key distinction in this context.

Correct Answer: B

Rationale: The correct answer is B: participatory. This is because the nurse managers are actively involved in designing their unit budgets to meet the established goals set by the executive administrative leaders. In a participatory budgeting approach, input and collaboration from lower-level managers or staff members are encouraged, allowing for a more inclusive and bottom-up decision-making process. This approach fosters ownership, accountability, and transparency in budget planning. Summary of other choices: A: top-down - This approach involves setting budget goals and directives from the top management without much input or involvement from lower-level managers. Not applicable in this scenario. C: iterative - This approach involves making continuous adjustments and refinements to the budget based on feedback and performance data. Not explicitly mentioned in the scenario. D: incremental - This approach involves making small adjustments to the previous budget period. While there may be some incremental changes, the scenario emphasizes a more collaborative process involving nurse managers, making this choice less suitable.

Correct Answer: A

Rationale: The correct answer is A: Individual state boards of nursing. State boards of nursing are responsible for regulating nursing practice within their respective states, including establishing rules and regulations to ensure safe and competent care. They set standards for licensure, education, and practice, as well as enforce disciplinary actions when necessary. State boards have the authority to govern nursing practice based on state laws and regulations. Employers, the US Department of Health and Human Services, and local health officials do not have the regulatory power to establish the rules for nursing practice at a state level.

Correct Answer: B

Rationale: The correct answer is B: length of hospital stay. DRGs aim to reduce healthcare costs by incentivizing hospitals to provide efficient care and discharge patients sooner. Shortening the length of hospital stay helps decrease overall healthcare expenses without compromising the quality of care. Choices A, C, and D are incorrect because DRGs focus on the duration of hospitalization, not necessarily on hospital admission rates, outpatient services, or specialty groups. Shortening hospital stays is a more direct way to control costs within the inpatient setting.