Ethics and Issues in Contemporary Nursing

Correct Answer: C

Rationale: The correct answer is C: Clara Maas. Clara Maas died after deliberately acquiring two bites from yellow fever carrier mosquitoes to provide care during the Spanish-American War. This is correct because Clara Maas was a real historical figure known for her selfless dedication to nursing and her sacrifice to help others. Florence Nightingale (A) is renowned for her work in nursing during the Crimean War, but she did not die from acquiring yellow fever. Margaret Hoolihan (B) and Sairy Gamp (D) are fictional characters and not relevant to the historical context of the Spanish-American War.

Correct Answer: A

Rationale: The correct answer is A: Work with the patient and family to create an advanced plan of care. This is the best way to avoid ethical dilemmas because it involves proactive decision-making and communication among all parties involved. By creating an advanced plan of care, the patient and family can outline the patient's preferences, values, and goals for future care, ensuring that decisions align with the patient's wishes. This helps prevent potential conflicts and ensures that everyone is on the same page regarding the patient's care. Choices B, C, and D are incorrect: B: Explaining cognitive decline does not directly address how to avoid ethical dilemmas and may cause unnecessary distress. C: Discussing religious and spiritual concerns is important but may not specifically address future ethical dilemmas related to care decisions. D: Identifying family members in control of decision-making does not necessarily prevent ethical dilemmas and may overlook the patient's autonomy and preferences.

Correct Answer: A

Rationale: The correct answer is A: Emergency Medical Treatment and Active Labor Law (EMTALA). This act prohibits hospitals from transferring patients in active labor or with an emergency condition based on insurance status or ability to pay. It ensures that all individuals, regardless of insurance or immigration status, receive necessary emergency medical treatment. The other choices are incorrect because: B: Health Insurance Portability and Accountability Act (HIPAA) protects patient privacy and does not address transfer of patients in active labor. C: Patient Self-Determination Act focuses on patient autonomy in making healthcare decisions, not on preventing transfer based on insurance status. D: The Patient Safety and Quality Improvement Act promotes patient safety and quality improvement but does not specifically address transfer of patients in active labor.

Correct Answer: B

Rationale: The correct answer is B: Pareto chart. A Pareto chart is a quality improvement tool used to prioritize and focus efforts on the most significant causes of a problem. In this case, the hospital used the chart to identify the main causes of medication errors, helping them to allocate resources efficiently. The Pareto principle states that roughly 80% of effects come from 20% of causes, making it a powerful tool for process improvement. A: Run chart is used to track data over time but does not prioritize causes like a Pareto chart. C: Flowcharts are used to map out processes and are helpful for understanding the sequence of activities, not for prioritizing causes. D: Cause-and-effect diagrams (Fishbone or Ishikawa diagram) are used to identify and organize potential causes of a problem but do not prioritize them like a Pareto chart. In summary, the Pareto chart is the most appropriate tool in this situation because it helps focus efforts on the most significant causes

Correct Answer: A

Rationale: The correct answer is A: Unfreeze. In this scenario, the handout is aimed at creating dissatisfaction with the current state of health insurance among employees, which aligns with the unfreezing stage of Lewin's planned change model. Unfreezing involves creating awareness of the need for change by highlighting deficiencies in the current state. The handout is triggering employees to reevaluate their current health insurance and consider alternative options. Choices B, C, and D are incorrect because they do not capture the initial stage of creating dissatisfaction and readiness for change, as seen in the unfreezing phase.