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Flashcards in Nursing Responsibilities Deck (70)
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1
Q

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 listed to both nurses and management to make recommendations that were not legally binding. This type of settlement is referred to by what term?

A. Collective bargaining
B. Binding arbitration
C. Mediation
D. Grievance

A

C. Mediation

Rationale: Mediation enlists the help of a trained person to listen to both sides; however, recommendations are not legally binding. Collective bargaining is a process whereby workers organize under the depredation of a union in order to share a degree of power with management to determine selected aspects of the conditions of employment. Binding arbitration means that ll parties must obey the arbitrator’s recommendations. Grievance is a term associated with a negative workplace event that results in an allegation by an employee that he or she has not been treated fairly and equitably.

2
Q

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 nurse accepts the role, what affect will unionization have on the nurse’s new position?

A. The nurse can be represented by the union because charge nurses aren’t considered part of the management team
B. Charge nurse is part of the management team, so union participation would be a conflict of interest
C. The nurse can file a grievance that will be arbitrated automatically by the union
D. The nurse is ineligible for collective bargaining activities that deal with unfair labor practices

A

A. The nurse can be represented by the union because charge nurses aren’t considered part of the management team

Rationale: serving as charge nurse is part of the nurse’s professional role and not a management function

3
Q

A nurse has heard rumors that other nurses are interested in unionizing but knows little about the purpose of unions. What should be the nurse’s first action?

A. Contact an arbitrator who has worked with other nurses in unions
B. Question 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

A

D. Review the National Nurses United website for collective bargaining information

Rationale: The National Nurses United website gives information about collective bargaining for nurses. None of the other options are as likely to provide unbiased information on the topic

4
Q

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, where should the union organizer 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. At the facility to discuss nursing concerns

A

C. In homes or local businesses with staff nurses

Rationale: the union representative meets with laborers (staff nurses) at a non-work setting to gather info about grievances

5
Q

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. What is the purpose of a signed union authorization card?

A. It authorizes the union to serve as his or her legal representative
B. It indicates that the person is requesting additional information about collective bargaining
C. It indicates the nurse desires to share information about grievances
D. It gives permission for union dues to be deducted from pay

A

A. It authorizes the union to serve as his or her legal representative

Rationale: a signature of a union authorization card indicates that the nurse gives the union the right to serve as legal representation

6
Q

A group of RNs wish to seek union representation that would protect all workers in the agency including non-licensed assistive personnel and non-nursing employees such as nutritionists and dietary workers. The type of union being sought is the strongest collective group and is known by what term?

A. An occupational union
B. An industrial unionism
C. A union shop
D. A right-to-work bargaining organization

A

B. An industrial unionism

Rationale: an industrial union is a single union for all workers in the agency. Occupational unionism is a type of union in which each occupation within a given company has separate unions. Union shop refers to a worksite that requires all new employees in a specific work group to join the union. A nurse in a right-to-work state can choose not to become a union member yet receive the benefits from the union contract

7
Q

Physical therapists are represented by a union, nurses are represented by a separate union, and pharmacists have yet another union within a single agency. This type of union representation is known by what term?

A. Occupational unionism
B. Industrial unionisms
C. Union shop
D. Power sharing

A

A. Occupational unionism

Rationale: occupational unionism indicates separate unions for each occupation in an agency

8
Q

Historically, what movement most influenced unionization in American health care agencies/hospitals?

A. Immigration laws protected foreign employees from discrimination in hiring or discharge based on national origin and citizenship status
B. Women entered the workforce, gaining voice to support unions
C. The Industrial Revolution led to poor working conditions and the need to protect workers
D. Nurses were exposed to communicable disease, which led to death and disability

A

C. The Industrial Revolution led to poor working conditions and the need to protect workers

Rationale: the Industrial Revolution led to people working in factories where poor and unsafe working conditions were widespread

9
Q

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

A

C. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession

Rationale: Nurses are client advocates and promotion of professionalism is valued as evidenced by the public’s opinion related to honesty and professionalism

10
Q

A novice nurse asks about the difference between mediation and binding arbitration. The response should be based on which statement?

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

A

B. Binding arbitration is a formal discussion between labor and management in which the arbitrator’s recommendations are compulsory

Rationale: binding arbitration requires that both parties meet in formal talks, and all parties must obey the arbitrator’s recommendations

11
Q

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 non-striking agency nurses decides to stop work to support the nurses who are striking. Which statement describes this action?

A. It is placing nurses at risk for a lawsuit because their direct employer did not cause the strike
B. The union in question must be an industry union representing both parties
C. The nurses are participating in a sympathy strike, which, if done correctly, is legal
D. The striking nurses must pay for any losses incurred by the agency during the strike

A

C. The nurses are participating in a sympathy strike, which, if done correctly, is legal

Rationale: A sympathy strike occurs when a union stops work to support the strike of another union. None of the other options accurately describe the presented situation

12
Q

Which organization is the largest union in the United States representing registered nurses?

A. American Nurses Association
B. United American Nurses
C. National Nurses United
D. National Labor Relations Board

A

C. National Nurses United

Rationale: In 2009, the National Nurses United became the largest union representing nurses as a result of a merger between the United American Nurses, California Nurses Association. National Nurses Organizing Committee, and Massachusetts Nurses Association

13
Q

A nurse is interested in working in a large trauma center that is unionized but doesn’t want to join the union or pay fees. The nurse is not required to join or pay fees to the union based on which law?

A. National Labor Relations Act
B. Right-to-work law
C. National Labor Relations Act
D. Taft-Hartley Act

A

B. Right-to-work law

Rationale: The right-to-work law prohibits membership or payment of union dues or fees a condition of employment, either before or after hiring

14
Q

A group of nurses are assembling outside a hospital protesting the use of foreign nurses after several nurses were terminated due to what the hospital called recurring “decreased census”. The nurses carry signs with messages asking potential patients to seek care elsewhere. The local newspaper picked up the story, and the hospital is receiving negative press. The nurses are participating in what action?

A. Picketing
B. Collective bargaining
C. Striking
D. Arbitration

A

A. Picketing

Rationale: Picketing is a form of protest in which people (called picketers) congregate outside a place of work or location where an event is taking place. Often this is done to dissuade others from going in (“crossing the picket line”), but it can also be done to draw public attention to a cause

15
Q

A hospital is seeking a 2.5% wage reduction for all nurses as part of a new balanced budget plan; however, the plan provides for raises for upper-level management. This plan resulted in a call for a union to protect the nurses. When the union representative arrives, what questions should the nurse ask? SATA.

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?

A

B. How effective has the union been in representing nurses’ best interest?
C. What percent of dues pays union personnel salaries?
E. If arbitration is unsuccessful and a stroke occurs, will nurses receive compensation during the strike?

Rationale: 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

16
Q

During the pre-election phase for unionization, which actions by union representatives are prohibited by the National Labor Relations Board? SATA.

A. Scheduling a meeting in the agency’s cafeteria to determine employees’ interest in unionization
B. Distributing non-documented information that female nurses receive lower annual performance evaluations that 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

A

A. Scheduling a meeting in the agency’s cafeteria to determine employees’ interest in unionization
B. Distributing non-documented information that female nurses receive lower annual performance evaluations that do male nurses
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

Rationale: Union representatives must meet in non-work areas. Union representatives must not spread rumors of prejudices. Neither the union nor employees can spread falsehood about potential job loss or repercussion in the event of unionization. Union representatives cannot sign cards for employees

17
Q

It is important to realize that nurses may seek unionization if what situation occurred? SATA.

A. Physicians rotate on-call coverage among group members for complication long-term clients
B. Adequate staffing is provided 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 their 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 two consecutive days to educate staff on new cardiac monitoring procedures while following normal staffing patterns

A

C. Incident report trends indicate medication errors are caused by shift reports being taped and heard after nurses from their prior shift have left the unit
E. Staff development activities are planned daily at 8 AM for two consecutive days to educate staff on new cardiac monitoring procedures while following normal staffing patterns

Rationale: 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)

18
Q

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? SATA.

A. Seek individuals to spy on coworkers who are possible union supporters
B. Photograph employees participating in information sessions about unionization
C. Visit managers outside work to gain their perception of popularity of unionization
D. Threaten that, should the union win, the company will relocate when there is no intention to relocate
E. Require employees to declare their position on unionization prior to pick up paychecks

A

A. Seek individuals to spy on coworkers who are possible union supporters
B. Photograph employees participating in information sessions about unionization
D. Threaten that, should the union win, the company will relocate when there is no intention to relocate
E. Require employees to declare their position on unionization prior to pick up paychecks

Rationale: During the pre-election period, management may not solicit spying. During the pre-election period, management may not photograph employees engaged in union activities. During the pre-election period, management may not lie about what will happen if the union is the victor in an election. During the pre-election period, management may not question employees about their preferences regarding union activity

19
Q

A bill is pending in the state legislature that will mandate teaching health promotion related to smoking cessation. Which action by the nurse should have the greatest impact on the passage of the bill?

A. Explain the rationale for the bill to the school board
B. Contact the elected representative’s office by telephone to request support for the bill
C. Support a health advocate to run for election as state representative
D. Tell all students about the bill

A

B. Contact the elected representative’s office by telephone to request support for the bill

Rationale: Telephone calls are an effective means of communicating your support for a bill, next to a face-to-face meeting; ask to speak to the staff person assigned to the bill or issue for which the call is being made. After introducing yourself, give a brief and simple message such as, “Please tell senator/representative (name) that I support (bill number)”

20
Q

Time is becoming crucial for the nurse to address issues related to sponsoring programs to include nearing aid costs as part of Medicare coverage. The nurse involved in grassroots political actions realizes that the least timely method of reaching elected officials would be via what route?

A. Letter
B. Telephone
C. Email
D. Facsimile (fax)

A

A. Letter

Rationale: Sending letters is the least timely mode by which to communicate with elected officials; because of the anthrax decontamination process that is now in place, delivery of U.S. mail to Congress and to the White House may be delayed by as long as 3 months, making letters an inefficient means of communicating with policymakers

21
Q

A nurse would like to advocate for increased protective services and reporting mechanisms for elder abuse and attends the “meet the candidate” session at the town hall meeting. This is an important time for the nurse to implement what action?

A. Educating the public’s about the nurse’s political platform
B. Being spontaneous and not deliver a rehearsed speech
C. Addressing the person as “candidate” rather than using a first name that implies a working relationship
D. Learning what the key issues are in the candidate’s platform

A

D. Learning what the key issues are in the candidate’s platform

Rationale: Town hall gatherings with nurses allow the candidate to talk about his or her platform to a group of interested voters and afford nurses an opportunity to understand the candidate’s vision and to voice their opinions and concerns about health care issues

22
Q

A nurse would like to obtain background information and learn the political platform of a candidate who is running for national office. The nurse should contact what organization?

A. National Registry for Candidates
B. American Nurses Association Nurses
C. National League of Nurses
D. National Council of State Boards of Nursing

A

B. American Nurses Association Nurses

Rationale: Through legislative updates, American Nurses Association Nurses Action center keeps members up-to-date about background information and the platforms of candidates who are running for national office and also provides updates about key bills as they move through the legislative process

23
Q

Political action committees (PACs) are established for what purpose?

A. Financially supporting candidates
B. Persuading policymakers to support certain policies
C. Lobbying legislators
D. Recommending health care policy

A

B. Persuading policymakers to support certain policies

Rationale: A PAC is an arm of an organization, association, or labor union that is formed to persuade a policymaker to support a certain policy or program or, more often, to ensure the election or re-election of policymakers who support the organization’s goals

24
Q

When the policy process is compared with the nursing process, identifying the issue is consistent with which step of the nursing process?

A. Assessment
B. Diagnosis
C. Planning
D. Implementation

A

B. Diagnosis

Rationale: The diagnosis step in the nursing process is consistent with identification of the targeted issue in the political process. As politically active nurses soon discover, effective involvement in policy development and political activities requires efforts similar to those used in the nursing process. The policy process and the nursing process are systematic approaches that use the nursing process for decision making

25
Q

It is important for nurses to know the functions of the branches of the federal government. At a local meeting of the state nurses’ association, an officer reminds members that the branch that can originate major policy initiatives is the _____ branch.

A. Executive
B. Legislative
C. Judicial
D. Administrative

A

B. Legislative

Rationale: The legislative branch possesses the sole federal power to enact legislation; the legislative branch originates and promotes major policy initiatives and has the power to override a presidential veto

26
Q

A concerned nursing student calls the office of an elected official to voice support for the bill to ban smoking in all public places. The secretary asks, “Are you a constituent?” What does the term constituent mean?

A. A member of a professional organization who supports the organization’s political issue
B. A citizen who is registered and is eligible to vote for a representative
C. An elected official who proposes legislation to be considered as a potential law
D. A member of the House of Representatives who is seeking support for a particular bill

A

B. A citizen who is registered and is eligible to vote for a representative

Rationale: A constituent is a citizen who can vote for candidates in elections for representations at local, state, and federal government levels

27
Q

A person who is covered by Medicaid moves from one state to another and asks the nurse at the health department why the benefits changed. What is the nurse’s correct responses?

A. “Local government controls which benefits each county can provide to Medicaid recipients.”
B. “The federal government doesn’t fund any part of Medicaid, so each state must find ways to pay for benefits”
C. “Each state determines benefits on the basis of the present economy”
D. “Medicaid is funded by both state and federal governments, but benefits vary from state to state”

A

D. “Medicaid is funded by both state and federal governments, but benefits vary from state to state”

Rationale: Medicaid is a program that is funded through a combination of state and federal funds; thus, benefits vary from state to state

28
Q

Throughout the history of health care in our nation, one particular piece of federal legislation provided funds for hospital construction. As the number of hospitals rapidly increased, the need for nurses to staff hospitals also increased, and the shift from community-based nursing care to hospital-based nursing care began. What fundamental piece of legislation was the basis of this action?

A. Sheppard-Towner Act
B. Hill-Burton Act
C. Veterans Bill
D. Access to Health Care Bill

A

B. Hill-Burton Act

Rationale: The Hill-Burton Act, also known as the Hospital Survey and Construction Act, was enacted in 1950. This act provided funding that resulted in a boom in the construction of hospitals across the country. As the number of hospitals increased rapidly, so did the need for nurses to staff the hospitals. Thus the nurse’s role was shifted from community and public health settings to the acute care setting

29
Q

Members of a state’s constituent member association meet at a local restaurant to plan a Nurse Walk to support the local food bank. When entering the restaurant, the nurses note the environmental inspection reports shows deficiencies because food handlers were not wearing hairnets and rodents were spotted, resulting in a score of 60/100. This certificate of inspection is health policy enforced at which level of government?

A. Local
B. State
C. Federal
D. International

A

B. State

Rationale: Healthy policy at the state level is responsible for ensuring food safety in restaurants

30
Q

Soon, the largest segment of the population will be those over age 65 years. To advocate for this vulnerable population, a nurse was a strong supporter for the Medicare Modernization Act (Medicare Part D), which focuses on what?

A. Providing vision care benefits to elderly persons who were diagnosed as legally blind
B. Removing limits to access to mental health/substance abuse services which are the most commonly used services in this population
C. Providing coverage for medications for Medicare enrollees that constituted a huge expense for the elderly
D. Expanded the practice opportunities for advanced practice registered nurses (APRN) who provide the majority of care for this population

A

C. Providing coverage for medications for Medicare enrollees that constituted a huge expense for the elderly

Rationale: The Medicare Modernization Act provided medication benefits to Medicare recipients and encouraged policymakers to have oversight to ensure drug effectiveness

31
Q

If a nurse is practicing in a mental health agency could only belong to one professional organization, what criteria could be used to select the organization with the biggest impact?

A. The American Nurses Association has a strong voice representing the nation’s entire RN population
B. Speciality organizations such as the American Psychiatric Nurses Association lobby for higher education requirements for nurses
C. State nursing associations have limited power because they can lobby only state representatives
D. Professional organization such as The American Association for the History of Nursing (AAHN) record the history of mental health nursing

A

A. The American Nurses Association has a strong voice representing the nation’s entire RN population

Rationale: The American Nurses Association is the voice for all registered nurses

32
Q

A group of nurses meet with a state representative to explain the importance of allowing RNs the right to sign death certificates for patients who were under their care. As constituents and nurses, they requested that the senator vote against the bill restricting this practice. The nurses are serving in what role?

A. Lobbyists
B. Policymakers
C. Officials with regulatory power
D. Advocates for the Patient Safety and Quality Improvement Act

A

A. Lobbyists

Rationale: Lobbyists hope to educate and convince policymakers to respond positively to a particular position on an issue or to follow a particular course of legislative or regulatory action

33
Q

A nurse is concerned about older persons living alone at home without telephone service to contact emergency services. The nurse is advised to take part in grassroots efforts to address the situation. The nurse would take what action to increase effectiveness of the effort? SATA.

A. Posting signs to support the county’s political candidates whose platform support services for poor and underserved person such as older adults
B. Visiting with local politicians running for office and ask specific questions such as, “Would you support providing free emergency telephone service for older adults living alone?”
C. Limiting voting to only presidential elections in which a candidate promises to initiate health care reform related to Medicare for older adults
D. Joining the American Nurses Association and constituent member association
E. Contacting representatives from surrounding states to garner support for free medical alert systems for older adults

A

A. Posting signs to support the county’s political candidates whose platform support services for poor and underserved person such as older adults
B. Visiting with local politicians running for office and ask specific questions such as, “Would you support providing free emergency telephone service for older adults living alone?”
D. Joining the American Nurses Association and constituent member association

Rationale: Working in local political campaigns in an effective grassroots effort. Visiting, emailing, calling, and faxing local politicians to support free emergency telephone service for older adults is a grassroots tactic. Joining ANA and state nursing associations supports these organizations’ lobbying efforts and is thus a way for individual nurses to influence the issues that nursing associations support

34
Q

A nurse is interested in learning more about health policy and how it might impact nursing practice. She is especially interested in The Patient Protection and Affordable Care Act (PPACA) and how it will travel through the three branches of the federal government. When researching the roles of the legislative branch of the federal government what does the nurse learns about this branch? SATA.

A. It determines which laws are constitutional, such as recently deciding the PPACA is constitutional because it is a form of taxation
B. It has the exclusive power to determine where federal dollars will be spent, such as supporting the PPACA
C. It consists of the Office of the President and 15 executive departments that supported the PPACA
D. It has the power to veto laws found constitutional by the Supreme Court and therefore could veto the PPACA
E. It can override a Presidential veto, making it possible to amend the PPACA even without approval of the president

A

B. It has the exclusive power to determine where federal dollars will be spent, such as supporting the PPACA
E. It can override a Presidential veto, making it possible to amend the PPACA even without approval of the president

Rationale: The legislative branch possesses the sole power to enact legislation, tax citizens, and allocate federal spending. The legislature can override a presidential vote

35
Q

A nurse who is interested in graduate school wants to learn about recently passed legislation regarding changes in Medicare reimbursement for care provided by clinical nurse specialists. The best source for information on changes in federal programs is the ______________.

A

Federal register

Rationale: The Federal Register is the best source of information about proposed rules and regulations for newly enacted legislation and about changes to existing rules for federal programs

36
Q

The greatest barrier to access to health care for a poor Hispanic person living in downtown Chicago is lack of health ______________.

A

insurance

Rationale: Lack of health insurance is the greatest barrier to access to health care and it has tremendous impact on an individual’s health. Studies have consistently found that the uninsured receive less than adequate health care

37
Q

Another name for an eligible voter is a _______________.

A

Constituent

Rationale: a constituent is a citizen who has the opportunity to vote for candidates in elections for representation at the local, state, and federal levels

38
Q

A nurse would like to obtain background information about a political candidate who is running for national office. The nurse should contact which organization?

A. Federal register
B. National League of Nurses
C. American Nurses Association
D. National Council of State Boards of Nursing

A

C. American Nurses Association

39
Q

Which organization represents nurses and represents healthcare issues on a national level?

A. Nurses United Association
B. Service Employees International Union
C. National Nurses Association
D. American Nurses Association

A

D. American Nurses Association

40
Q

Affordability Care Act

A

Affordable health insurance available to more people. The law provides premium tax credits that lower costs for households with incomes between 100% and 400% of the federal poverty level

41
Q

Sheppard-Towner Act

A

Provide funding for nursing service. It provided states with matching funds to establish prenatal and child health centers staffs by public health nurses. Also, its goal was reduced maternal and infant mortality rates by teaching women about personally hygiene and infant care

42
Q

The Emergency Medical Treatment and Labor Act (EMTALA)

A

Any person will receive emergency medical care regardless of citizenship, legal status, and ability to pay. Applies to hospitals that receive payments from Medicare

43
Q

Hill-Burton Act

A

Provided federal funding for hospital construction. Shifting nurses primary employment setting from public health to hospital

44
Q

1999 Safe Staffing Bill for California

A

Legislations requiring minimum nurse-to-patient staffing ratios in acute care hospitals

45
Q

California Assembly Bill (AB 394)

A

California State Department of Health Services to establish unit-specific minimum staffing levels for licensed nurses (RN, LVN) in acute care hospitals

46
Q

Veterans Bill

A

New protections for student veterans, new aid for veterans hurt by the ongoing pandemic and long sought-after improvements to VA services aimed at women veterans, provides new financial assistance programs for homeless veterans, etc

47
Q

U.S. Health policy may be developed and implemented at which of the following levels? SATA.

A. Neighborhood
B. Federal
C. Global
D. State

A

B. Federal
D. State

48
Q

The nurse would like to know the steps to inviting a union into a facility. The nurse would be correct, if he described the steps of the unionization process as…

A
  1. Interested nurses meet to talk about issues of concern and forms a union organizing committee
  2. Nurses who wish to unionize host an “organizing drive” to determine overall interest in unionizing. If enough interest exists a union rep will be contacted to discuss the issues of concern, such as, unsatisfactory working condition and no possibly making improvement under the existing management circumstances
  3. Union rep determines if the efforts to organize the nurses in the facility will be successful. Determination is made by a process of “signing cards.” The nurse’s signature on a union authorization card is authorizing the union to serve as his/her legal reps. If 30% of employed nurses sign the cards this signals enough interest in union representation
  4. The union or facility management must contact the National Labor Relations Board (NLRB) to request a formal vote
  5. An anonymous process is used to hold a secret ballot election (the employer doesn’t know how each nurse votes). The union will win if a majority vote 50% +1 is obtained in favor of the union. If a true tie is obtained 50/50, the win goes to the employer and the union is not approved to represent the nurses
  6. The management and union representatives must honor the results of the election. If the union wins the election the employer must reorganize the union.
49
Q

During the pre-election period, which actions by hospital management are prohibited?

A. Photograph nurses working on the unit while completing skills training and union leaders are meeting with management
B. Visit with nurse managers outside of the work setting to discuss the probability of the union winning the election
C. Pass out literature, explaining the genetics of remaining non-unionized, to employees as they leave work 2 days before the election
D. Photograph employees participating in information sessions about union representation

A

D. Photograph employees participating in information sessions about union representation

50
Q

Which of the following are NOT one of the four major recommendations made by the IOM in 2010? SATA.

A. Nurses should practice to the full extent of their education and training
B. Nurses shouldn’t be full partners, with physicians and other healthcare professionals, in redesigning healthcare in the U.S.
C. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression
D. Effective workforce planning and policy making do not require better data collection and information infrastructure

A

B. Nurses shouldn’t be full partners, with physicians and other healthcare professionals, in redesigning healthcare in the U.S.
D. Effective workforce planning and policy making do not require better data collection and information infrastructure

51
Q

Citizens and individuals approach ________ with a problem to be solved or to suggest a policy option to a health problem they have identified.

A. Stakeholders
B. The house of congress
C. Legislators
D. The senate

A

C. Legislators

52
Q

Public health policies are created and established to address the needs of a whole population, examples of public health policies would include (SATA):

A. Ensuring low cost utility service
B. Requiring private health insurance
C. Preventing disease outbreaks
D. Promoting physical activity and fitness
E. Ensuring safe food and water in communities
F. Educating the public about healthier choices

A

C. Preventing disease outbreaks
D. Promoting physical activity and fitness
E. Ensuring safe food and water in communities
F. Educating the public about healthier choices

53
Q

A nurse is concerned about older persons living alone at home without a cell phone or landline service to contact emergency services. The nurse is advised to take part in grassroots efforts to address the situation. The nurse would take what action(s) to increase the effectiveness of the effort? SATA.

A. Contacting representatives from surrounding States to garner support for free medical alert systems for older adults
B. Joining the American Nurses Association and constituent member association
C. Visiting with local politicians running for office and asking specific questions such as, “Would you support providing free emergency telephone services for older adults?”
D. Limiting voting to only presidential elections in which a candidate promises to initiate healthcare reform related to Medicare for all
E. Posting signs to support the local county political candidates whose platform includes support serves for poor and underserved members of the community

A

B. Joining the American Nurses Association and constituent member association
C. Visiting with local politicians running for office and asking specific questions such as, “Would you support providing free emergency telephone services for older adults?”
E. Posting signs to support the local county political candidates whose platform includes support serves for poor and underserved members of the community

54
Q

What are the actions associated with Lewin’s Change Theory - Unfreeze

A
  1. Survey the organization to understand current state
  2. Frame the issue as one of organization-wide importance
  3. Emphasize and create a compelling message as to “why” the change must take place
  4. Understand why change has to take place
55
Q

What are the actions associated with Lewin’s Change Theory - Change

A
  1. Provides lots of opportunities for employee involvement
  2. Communicate often
  3. Dispel rumors
  4. Explain exactly how the changes will effect everyone
  5. Deal with problems immediately
56
Q

What are the actions associated with Lewin’s Change Theory - Refreeze

A
  1. Anchor changes into the culture
  2. Ensure leadership support
  3. Provide support and training
57
Q

Which independent federal agency protects the rights of employees to unite to improve their wages and working conditions?

A. National Employee Protection Agency
B. American Nurses Association
C. National Nursing Union
D. National Labor Relations Agency

A

D. National Labor Relations Agency

58
Q

A nurse is considering employment where the nurses belong to a collective bargaining unit. How will the potential employee benefit from the collective bargaining unit? SATA.

A. Organization of social activities
B. Negotiation for wages
C. Negotiation for improved working environment
D. Free collective bargaining membership
E. Preferred work hours and childcare accommodations

A

A. Organization of social activities
B. Negotiation for wages
C. Negotiation for improved working environment

59
Q

What are the steps included in the process of Health Policy becoming a law? SATA.

A. Administrative support
B. Executive Direction
C. Judicial decision
D. Popular initiative
E. Report to the federal register
F. Legislative Action

A

B. Executive Direction
C. Judicial decision
F. Legislative Action

60
Q

It is important for nurses to know the functions of the branches of the federal government. At a local meeting of the state nurses’ association, an officer reminds the members that the branch that can propose major policy initiatives is…

A. The administrative branch
B. The judicial branch
C. The legislative branch
D. The executive branch

A

C. The legislative branch

61
Q

Private Health Insurance

A

Paid for in part or entirely by the individuals being covered. Several different public options are available in each state, but strict eligibility requirements exist. Private health insurance can be offered through an employer or can be purchased by individuals

62
Q

Medicaid

A

Public health insurance administered by states, combining state and federal funds for low-income individuals and families. Each state determines eligibility guidelines such as income, family size, disabilities, pregnancy status and immigration status. States also determine the coverage provided and the cost to participants (if any)

63
Q

Medicare

A

Federal public health insurance for adults over the age of 65, people with certain disabilities and people with ESKD

64
Q

California State Health Insurance exchanges (Affordable Care Act, aka “Obama Care”)

A

One of ten state run exchanges that uses an “active purchaser” model, meaning that they negotiate directly with carriers to make sure that rates, networks, and benefits are at least at the minimum coverage level set by the government

65
Q

Public Health Insurance

A

Insurance that is subsidized or paid for entirely by public (government) funds. The primary public health programs in the US are Medicare, Medicaid, and CHIP

66
Q

Children’s health insurance program (CHIP)

A

A federal-state partnership that serves certain children and families who do not qualify for medical assistance but cannot afford private coverage

67
Q

What was the purpose of the IOM report?

A. Make recommendations for an action-oriented blueprint for the future of nursing
B. Improve the health of the U.S. population through the contribution’s nurses can make to the delivery of care
C. Ensure nursing students earn extra credit points for their passport assignments
D. Provide financial support for nurses to achieve higher levels of education and training

A

B. Improve the health of the U.S. population through the contribution’s nurses can make to the delivery of care

68
Q

Mandatory overtime and reduced RN staffing have resulted in decreased client satisfaction and a sentinel event. Management is unwilling to discuss a change in staffing and the staff nurses have an interest in union representation. A union organizer has been consulted and begins handing out “Union Authorization” cards. A staff nurse is approached to sign the card, if signed:

A. The nurse is asking to share a personal grievance
B. The nurse is seeking additional information about collective bargaining
C. The nurse is interested in joining the union organizers upcoming conference to support safe staffing initiatives
D. The nurses authorizes the union to serve as his or her legal representative

A

D. The nurses authorizes the union to serve as his or her legal representative

69
Q

The Nurse Practice Act (NPA) is the body of California law that mandates which responsibilities for RN professional practice? SATA.

A. Nursing professional scope of practice
B. Nursing professional will provide care to clients in select demographic groups
C. Provides minimal education requirements for nursing professionals
D. Established required nursing program curriculum
E. Allows for practice without the use of evidence based principles

A

A. Nursing professional scope of practice
C. Provides minimal education requirements for nursing professionals
D. Establishes required nursing program curriculum

70
Q

Nurses in a nonprofit hospital have expressed an interest in forming a union to secure fair wages and ensure client safety. The nurses seek guidance from a local union organizer. At which locations can the union organizer hold the initial meetings to answer the nurses questions?

A. In the break room of the worksite with staff nurses who are interested in union representation
B. Away from the worksite with a group of managers to learn both sides of the situation
C. In the parking lot of the worksite with nurses interested in union representation
D. In homes or a local restaurant with staff nurses seeking representation

A

D. In homes or a local restaurant with staff nurses seeking representation