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Practice Questions
- Nurses in a unionized hospital are paid “compensatory pay” when working holidays equal to the number of hours worked with no extra compensation. Although they have suggested changes during the annual survey of employee satisfaction, management refuses to consider another system for compensatory pay. A trained member listened to both nurses and management to make recommendations that were not legally binding. This type of settlement is termed: a. picketing. b. binding arbitration. c. (^) mediation. d. (^) grievance. ANS: C Mediation enlists the help of a trained person to listen to both sides; however, recommendations are not legally binding. DIF: Comprehension REF: p. 257
- A nurse has been asked to serve as the charge nurse on the evening shift. The agency where the nurse is employed is considering unionization. If the charge nurse position is accepted, this nurse: a. can be represented by the union because charge nurses are not considered part of the management team. b. is part of the management team, so union participation would be a conflict of interest. c. can file a grievance that will be arbitrated automatically by the union. d. is ineligible for collective bargaining activities that deal with unfair labor practices. ANS: A Serving as charge nurse is part of a nurse’s professional role and not a management function. DIF: Comprehension REF: pp. 263 - 264
- A nurse has heard rumors that other nurses are interested in unionizing but knows little about the purpose of unions. The nurse’s first action is to: a. contact an arbitrator who has worked with other nurses in unions. b. picket the agency where employed to gain inside information as to why unionization
is sought. c. sign the dual-purpose union authorization card. d. review^ the^ National^ Nurses^ United website for collective bargaining information. ANS: D The National Nurses United website gives information about collective bargaining for nurses. DIF: Application REF: p. 259
- Nurses in a nonprofit hospital have expressed an interest in forming a union to secure fair wages and ensure client safety. To form a core support group of nurses, the union organizer can conduct meetings to gather initial information: a. away from the worksite with a group of managers to learn both sides of the situation. b. at the worksite with staff nurses who are respected leaders. c. in homes or local businesses with staff nurses. d. after photographing management meeting to discuss their strategies to decrease interest in unionization. ANS: C The union representative meets with laborers (staff nurses) at a nonwork setting to gather information about grievances. DIF: Application REF: p. 260
- Mandatory overtime and reduction in RN staff have resulted in decreased client satisfaction and a sentinel event. Management is unwilling to discuss a change in staffing, and collective bargaining interest is sparked. A nurse is approached to sign a union authorization card. If signed, the card: a. authorizes the union to serve as his or her legal representative. b. indicates that the person is requesting additional information about collective bargaining. c. indicates the nurse desires to share information about grievances.
c. The Industrial Revolution led to poor working conditions and the need to protect workers. d. Nurses were exposed to communicable diseases, which led to death and disability. ANS: C The Industrial Revolution led to people working in factories where poor and unsafe working conditions were widespread. DIF: Comprehension REF: pp. 258 - 259
- In recent Gallop Polls, nurses were voted as the most honest with the highest ethical standards of all professions. How does this degree of professionalism affect nurses’ desire to participate in organized strikes? a. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client safety initiatives. b. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization. c. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession. d. (^) Nurses who strike can be legally punished for abandonment and negligence, considered to be professional misconduct. ANS: C Nurses are client advocates and promotion of professionalism is valued as evidenced by the public’s opinion related to honesty and professionalism. DIF: Application REF: p. 262
- A concern that nurses were being asked to perform tasks that went beyond the state’s nurse practice act was brought to the union’s attention. Nurses were informed that either mediation or binding arbitration will be used to resolve the issue. A novice nurse asks about the difference between these techniques and is informed that: a. mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor. b. binding arbitration is a formal discussion between labor and management in which
the arbitrator’s recommendations are compulsory. c. mediation uses a trained person to negotiate a legally binding plan. d. binding arbitration requires both labor and management to participate in discussions on the least destructive approach to allow self-governance by employees. ANS: B Binding arbitration requires that both parties meet in formal talks, and all parties must obey the arbitrator’s recommendations. DIF: Comprehension REF: p. 257
- A large corporation employs nurses all over the United States. Nurses in one agency learned that fellow nurses in another agency are striking because they are required to work 16-hour shifts to cover for nurses who have left due to unsafe staffing practices. The union of the nonstriking agency nurses decides to stop work to support the nurses who are striking; thus, this union: a. is placing nurses at risk for a lawsuit because their direct employer did not cause the strike. b. must be an industry union representing both parties. c. is participating in a sympathy strike , which, if done correctly, is legal. d. must pay for any losses incurred by the agency during the strike. ANS: C A sympathy strike occurs when a union stops work to support the strike of another union. DIF: Comprehension REF: p. 257
- A group of nurses interested in unionizing decides to contact the largest union in the United States representing registered nurses, which is the: a. American Nurses Association. b. United American Nurses. c. National Nurses United. d. National Labor Relations Board. ANS: C
a. Will the dues be used to support charity care when clients are unable to pay? b. How effective has the union been in representing nurses’ best interest? c. What percent of dues pays union personnel salaries? d. Are dues used to promote research for terminally ill clients? e. If arbitration is unsuccessful and a strike occurs, will nurses receive compensation during the strike? ANS: B, C, E Laborers (staff nurses) want a union with a successful track record of improving wages and benefits. Union dues are used to support union personnel, and the amount varies among different union groups; the higher the percentage of money that goes to pay union personnel salaries, the less money will be available to support members. Employers are not obligated to pay laborers during a strike, and unions may choose to pay employees while striking. DIF: Application REF: p. 263, Box 14- 1
- A hospital refused to purchase a better grade of utility gloves, even after learning that the cheaper utility gloves are easily punctured during routine use. This unsafe situation led nurses to seek unionization. During the pre-election phase for unionization, which actions by union representatives are prohibited by the National Labor Relations Board? (select all that apply) a. Scheduling a meeting in the agency’s cafeteria to determine employees’ interest in unionization b. Distributing nondocumented information that female nurses receive lower annual performance evaluations than do male nurses c. Distributing information about the benefits of unionization and grievances in a public parking garage located across from the hospital d. Suggesting to workers the likelihood of job loss should the union not win the election e. Signing authorization cards for employees who are on leave ANS: A, B, D, E
Union representatives must meet in nonwork areas. Union representatives must not spread rumors of prejudices. Neither the union nor employers can spread falsehood about potential job loss or repercussion in the event of unionization. Union representatives cannot sign cards for employees. DIF: Application REF: p. 259
- It is important to realize that nurses may seek unionization if: (select all that apply) a. physicians rotate on-call coverage among group members for complicated long-term clients. b. scheduling is presented that provides adequate staffing on holidays by rotation of time off for holidays among nurses. c. incident report trends indicate medication errors are caused by shift reports being taped and heard after nurses from the prior shift have left the unit. d. physicians, nurses, nutritionists, and physical therapists visit concurrently with clients to plan care. e. staff development activities are planned daily at 8 AM for 2 consecutive days to educate staff on new cardiac monitoring procedures while following normal staffing patterns. ANS: C, E Policies where shift reports are taped and heard after a prior shift has left have proved to lead to errors and unsafe care. Staff development activities should be scheduled to allow nurses to attend, and normal staffing patterns or time of training must coincide with nurses’ availability and ability to listen to and retain information (such as at the beginning or end of the shift while others provide coverage). DIF: Comprehension REF: p. 262
- Mandatory overtime and reduction in RN staff have resulted in decreased client satisfaction and a sentinel event. Management is unwilling to discuss a change in staffing, and collective bargaining interest is sparked. During the pre-election period, what actions by management are prohibited? (select all that apply) a. Seek individuals to spy on coworkers who are possible union supporters. b. Photograph employees participating in information sessions about unionization.
The domain of an educational institution is. edu. DIF: Knowledge REF: p. 276
- When paper-and-pencil medical records are compared with computer-based records: a. paper-and-pencil records provide controls to determine who has viewed the health information. b. information contained in a paper-and- pencil record has the capability of being more in-depth than that found in computer-based records. c. patients have the right to know that the confidentiality of their records is strictly maintained, regardless of the type of medical record used. d. patients must sign for each item of information released on the computer record. ANS: C Regardless of the type of record used, the Health Insurance Portability and Accountability Act (HIPAA) protects the confidentiality of the patient’s medical information and imposes legal consequences for those who breech confidentiality. DIF: Comprehension REF: p. 271
- A nurse is preparing a scholarly publication on the prevalence of hepatitis A worldwide. The most efficient and effective means of conducting an Internet search to gather information for this publication is to use: a. a search engine such as Google or Yahoo. b. a consumer health website. c. a decision support system. d. (^) MEDLINE database. ANS: D MEDLINE is one of the scientific and research scholarly databases, and it would be the most appropriate for use in gathering information for a scholarly publication. DIF: Comprehension REF: p. 276
- A consumer is learning about electronic health records at a local health fair and states, “I am worried that someone can read my health information and I really don’t understand the difference between privacy and confidentiality.” The nurse explains that an example of confidentiality would be:
a. a pledge that states, “I will hold matters pertaining to my patients in strict intimacy.” b. a patient who does not tell the physician that he has been treated for a sexually transmitted disease. c. a teenager who sustains a broken arm and in the emergency department and withholds information about her use of recreational drugs. d. locking medical records in cabinets to prevent unauthorized users from accessing patient information. ANS: A Confidentiality is keeping private the personal information that was given to a health care provider, unless others have a legitimate need to know. DIF: Application REF: p. 271
- A physician has installed a computer-based patient records system. An outside care provider who requests medical information must obtain the patient’s signed consent and then is assigned a password to gain access to the medical information. A monthly audit is conducted to determine for whom and for what purpose patient records have been accessed. This protection is referred to as: a. (^) privacy. b. confidentiality. c. security. d. data capture. ANS: C Security is the limitation of access to health care information through passwords and other precautions. DIF: Comprehension REF: p. 271
- A nurse walks up to a computer in the hallway and presses the index finger to the sensor, thereby gaining access to patient data. A few moments later another nurse performs the same steps and is granted access. A visitor who is watching from a room walks over and places the index finger on the sensor, only to receive an “error and access denied” message. Security is being maintained by: a. robot technology. b. biometric technology.
- A nurse is preparing a presentation using different websites to collect information. The nurse is concerned that contact information and the author’s credentials are not listed for one of the websites reviewed. Which criterion required to establish a reputable website is missing? a. Authority b. Objectivity c. Usability d. Currency ANS: A Authority is the criterion that is related to the credentials and background that have prepared an author to publish on the subject. DIF: Comprehension REF: p. 276
- A nurse is interested in locating reliable information concerning noninvasive blood glucose monitoring. Information is located, and the author is a scientist who conducted studies within the last year on the effectiveness of a particular noninvasive blood glucose monitor. The scientist received funding from a pharmaceutical company to support the studies. The URL indicates the pharmaceutical company site.com. The nurse is concerned about this information’s: a. (^) authority. b. (^) objectivity. c. accuracy. d. currency. ANS: B Sites sponsored by organizations such as pharmaceutical companies may influence the content. DIF: Comprehension REF: p. 276
- A nurse providing care at the bedside receives an “alert” that a patient’s stat potassium level is 2.5 and digoxin (Lanoxin) is scheduled. The nurse holds the medication and prevents a possible complication. This feature of the Electronic Health Record is available through which core function of EHR? a. Order entry/order management b. Decision support c. Patient support d. Administrative support ANS: B Decision support provides reminders about preventive practices, such as immunizations, drug alerts for dosing and interactions, and clinical decision making. DIF: Comprehension REF: pp. 268 - 269
- A nurse works on a unit where electronic health records (EHR) are being initiated and asks, “What is meant by ‘meaningful use’ standards that are in our education packet?” The best answer is that “meaningful use”: a. identifies a set of EHR proficiencies and benchmarks that EHR systems must meet to be certain that they are functioning to their maximum capacity and meeting this standard allows companies/organizations to qualify for funds to defray cost of the EHR from Medicare. b. refers to training competencies that all users must achieve to be able to access and transfer patient data/information. c. refers to a requirement that at least 50% plus one of all patients have data entered into the EHR. d. the requirement that rigorous confidentiality security is in place to protect all patient information from sources which have no right to the data. ANS: A Meaningful use is “A defined set of EHR capabilities and standards that EHR systems must meet to ensure their full capacity is realized and for the users (hospitals and physician practices) to qualify for financial incentives from Medicare.” DIF: Application REF: p. 271
- A nurse is caring for a patient who is to receive an antibiotic drug that causes severe skin damage when infiltrated. The order reads, “infuse over 1 hour by portacath.” The nurse accesses the Personal Digital Assistant for software that lists the steps to access a portacath. The nurse is using: a. electronic health records. b. (^) point-of-care technology. c. data management. d. telehealth. ANS: B Using a Personal Digital Assist device to access information at the bedside is considered point- of-care technology. The nurse was able to retrieve the steps for accessing a portacath electronically while remaining at the bedside. DIF: Comprehension REF: p. 273
- A nurse interested in quality improvement tools performed a search for cause and effect diagrams using www.ishikawa.com. A page opened that provided images and templates for performing fishbone diagrams. Which type of search did the nurse conduct? a. Quick and dirty b. Advanced c. Brute force d. Link searching ANS: C Brute force is a method of searching where you type in what you think might logically be a web address and see what happens. DIF: Comprehension REF: p. 275 COMPLETION
- Software programs that process data to produce or recommend valid choices are known as . ANS: decision support systems Decision support systems use software programs that process data to produce or recommend decisions by linking with an electronic knowledge base. DIF: Knowledge REF: p. 269 16
- Nurses and community officials are working together to ensure that churches and schools have needed supplies to provide shelter for large numbers of individuals in the event of a natural or manmade disaster. These activities represent which phase of a disaster continuum? a. Preparedness b. (^) Relief response c. Recovery d. Crisis intervention ANS: A Every disaster response begins as a local event known as the preparedness phase, which consists of planning, preparedness, prevention, and warning. DIF: Comprehension REF: p. 285
- A nurse at a school notices that several students have “blisters” on their bodies. Further investigation reveals that a terrorist incident has occurred, causing smallpox. If the chemical, biologic, radiologic, nuclear, and explosive (CBRNE) agent categories are used, this incident would be classified as: a. chemical. b. biologic. c. radiologic. d. nuclear. ANS: B The biologic category refers to diseases such as plague or smallpox. DIF: Comprehension REF: p. 284, Table 16 - 1
- The Metropolitan Medical Response System (MMRS): a. is totally financed by the federal government national disaster fund. b. consists of responders who have obtained specialized training and equipment to deal with mass casualty events. c. has a storehouse of medications and antidotes to be used during response in times of national emergencies. d. arranges for patient admissions to federal hospitals. ANS: B The MMRS responds to disaster with trained individuals who have expertise in this type of situation and who have the equipment required to be effective. DIF: Comprehension REF: p. 286
- A community in the New Madrid fault zone experiences an earthquake resulting in injuries from propelled objects and abrasions for many victims. The local supply of antibiotics is quickly exhausted. Local authorities would contact the: a. Commissioned Corps Readiness Force. b. Strategic National Stockpile. c. Department of Homeland Security. d. local Young Men’s Christian Association (YMCA). ANS: B
b. take charge of communicating with the news media. c. determine whether there is a credible threat of a terrorist attack. d. give priority for care to those with the greatest chance of survival rather than those most critically ill. ANS: D Care is shifted from categorizing patients at low, intermediate, and critical risk to using resources to serve those with the greatest likelihood of survival. DIF: Comprehension REF: p. 283
- During a community health fair the disaster medical assistance team (DMAT) informs participants that every community must be ready to provide disaster care. A participant asks, “In a disaster, the local community cannot possibly be effective, so why not have a plan to call federal agencies immediately to provide relief?” The correct response by the DMAT is: a. “Unless known terrorist activities involving mass destruction occur, the federal government does not become involved.” b. “The community is essentially the ‘first responder’ to any disaster.” c. “The preparedness phase of a disaster is the responsibility of the community, the relief response phase is assigned to state agencies, and the recovery phase is the responsibility of federal agencies.” d. “Unless local health care facilities are incapacitated, state and federal agencies will withhold assistance.” ANS: B Each disaster begins locally, and each community responds first and receives assistance from state and federal agencies when local resources are not adequate for the situation. DIF: Comprehension REF: p. 285
- A nurse who is conducting a staff in-service on the phases of a disaster continuum teaches participants that, during the impact/response stage, activities focus on: a. community awareness in anticipation of a terrorist attack or natural disaster. b. determining the effectiveness of the
disaster medical assistance team (DMAT). c. the use of an all-hazards approach. d. initiating response activities. ANS: D Response activities during the relief response phase consist of immediate actions to save lives and meet basic human needs. DIF: Comprehension REF: p. 288
- Following a terrorist attack, victims are exhibiting posttraumatic stress syndrome, and care providers are exhibiting compassion fatigue. Which federal response system should be initiated? a. Strategic National Stockpile b. Metropolitan Medical Response System (MMRS) c. Commissioned Corps Readiness Force d. National Disaster Medical System ANS: B The MMRS is concerned with deploying trained responders who are able to provide mental health care for victims and health care providers. DIF: Comprehension REF: p. 286
- The crisis communication officer may first inform the public or health care facility of a disaster or an act of terrorism. This representative has the responsibility to: a. contain the facts to within the administration group. b. incite the public to quickly take cover and obtain emergency supplies. c. provide understandable and straightforward facts about the event within the facility and possibly to the news media. d. inform the public that no information can be released until it has been confirmed by state and federal agencies. ANS: C The crisis communication officer is the first contact for patients, families, and employees within the facility or news media, so they may better understand the situation and know how to react and protect themselves. DIF: Comprehension REF: p. 289
