The name of the book is (HOSPITALS)

**there are multiple choices questions and some essay questions**

QUESTION 1

In Article 2 (Scott et al), what aspects of nursing are LEAST satisfying to patients?

o Interactions based on physical and technical aspects of care only.

o Human understanding of patients’ (and relatives) illness experience.

o Technical & clinical skills competence for safe outcomes.

o Time spent listening and talking (caring behaviors).

QUESTION 2

As stated in Article 2 (Scott et al). inadequate patient-nurse staffing result in patient death.

o True

o False

QUESTION 3

Each of the following statements regarding the structure and function of the clinical laboratory are true EXCEPT:

o The clinical pathology division of the clinical laboratory is under the direction of a pathologist.

o The microbiology staff isolates and identifies microorganisms collected from patients.

o The clinical chemistry staff measures various analytes in plasma and serum (from Dr. Thorn – for your information “analytes” refer to metabolic panel items like the following: sodium, potassium, chloride, bicarbonate, blood nitrogen (BUN), creatinine, glucose, calcium).

o Staff in the phlebotomy section can collect blood samples from patient, as shared responsibility with the nursing staff.

o All of the statements above are TRUE.

QUESTION 4

You are a CEO of a 200-bed community hospital in a RURAL Kentucky region with a PHYSICIAN SHORTAGE. Given your concern for the well-being of your citizens, you are grateful for the increase of nurse practitioners and physician assistants who moved into your community. Even though these nurse practitioners and physician assistants will not have admitting privileges to your hospital, they can refer admissions to your hospitalists. You decide to write an editorial to the local newspaper about their community value.

Address the following points in your Editorial:

Dear Rural Community Citizens:

What is a nurse practitioner? What duties (medical care) can a APRN (Advanced Practice Nurse) conduct?

What is a physician assistant? What duties (medical care) describes the role of a PA?

Encourage the local citizens to support the role of nurse practitioners and physician assistants in their community.

Why you, as the CEO of a hospital, finds value to having not only medical doctors but also NPs and PAs providing health care in the community.

Sincerely,

CEO

QUESTION 5

Approximately 40 – 50% of all hospital employees work in the department of nursing.

o True

o False

 

QUESTION 6

You are a graduate of the masters in HCA at WKU. You have held a mid-level management position in a hospital setting for the past 5 years. You are now interviewing for the position of Chief Operating Officer (COO) at a 120-bed Lifepoint-owned Hospital in Gallatin, Tennessee. One of several departments that will be under your responsibility, should you be selected, is the Department of Physical Therapy. The Director of the PT Department who recently received his doctorate degree in physical therapy from WKU will report directly to you.

How will you respond to the following questions posed by the Director of Human Resources during your JOB interview?

Question 1: tell me about your working knowledge of the role of physical therapists and physical therapy assistants and the services they provide in a hospital setting.

Question 2: Our PT department currently employs 10 FTEs (full time equivalents), in order to justify keeping this level of staffing going forward, describe how patient outcomes are affected by PT services.

QUESTION 7

Technology typically found on today’s patient care units include:

o Computerized axial tomography (CAT) scan, bar code-assisted patient identification, bedside computer terminals.

o Physician dictation station, hazardous waste incineration, telemonitoring equipment.

o Delivery robot, magnetic resonance imaging (MRI), interactive patient education systems.

o Bar code-assisted medication administration (BCMA), computerized medication dispensing machines, computers dedicated for physician use.

QUESTION 8

Which area within the Diagnostic Imaging Department uses radiopharmaceuticals to diagnose and treat disease?

o Radiation therapy (RT)

o Nuclear medicine (NM)

o Isotope tomography (IT)

o Radioactive fluoroscopy (RF)

QUESTION 9

Which diagnostic imaging modality provides the physician with a two-dimentional image?

o Chest radiography (x-ray)

o Computed tomography (CT) scans

o Magnetic resonance imaging (MRI)

o Ultrasound (US)

QUESTION 10

Diversity is a complex issue that reaches beyond rare, religion, and gender. For example, diversity also includes how to blend the work styles of three generations of hospital employees – Boomers, Gen X, Millennials. Healthcare leaders, like you will be someday, must demonstrate a commitment to building a DIVERSE workforce and developing an INCLUSIVE environment in which all personnel are respected, valued and engaged. Now to the essay questions:

a. Define the term “cultural competence” and its four components.

b. What is the “business case for diversity”? Said another way, when an healthcare organization embraces diversity and inclusion principles, how does it benefit the organization’s effectiveness?

c. The concept of inclusion, in concert with diversity and cultural competence, helps improve services in hospitals. Inclusion is:

QUESTION 11

__________ describes a specialty, ancillary service that uses high-energy ionizing radiation to destroy cancerous cells.

o Radiation Therapy.

o Radiation Oncology.

o Therapeutic radiology.

o All of the above.

Question 12

The most common size of patient-care or nursing unit is between:

o   8-10 beds per unit.

o   20 to 40 beds per unit.

o   60 to 70 beds per units.

o   >100 beds per centralized unit.

Question 13

Radiologic technologist are key personnel who perform diagnostic imaging examinations. As health care administrator, you will expect the following from this staff rule:

o   Cost-effective diagnostic imaging services

o   High-quality, accurate diagnostic images

o   Required education, certifications, and licensures

o   All of the above

QUESTION 14

This chapter informs you that hospitals significantly declined in number in the last several decades and that they are now better at controlling ALOS

a. Define the term ALOS

b. According to this author. What trend resulted in the significant decrease in hospital ALOS in the 1990s?

c. Find Table 2-2 in Chapter 2 page 15. State the ALOS trend for AHA-Registered Hospitals in the United States between 1980 to 2008

d. GO on-line to the internet to find the most current United States ALOS you can find Tell me what ALOS you found in what year AND compare it to the 5.5 days 2008 in Table 2-2

QUESTION 15

Clinical laboratories must be granted a certificate of compliance with CLIA (Clinical Laboratory Improvements Act) and it must be renewed every 2 years. CLIA 1988 was implemented by US Congress in 1988 as a measure to:

o   Prevent misdiagnosis of patients through misread or mixed up lab results.

o   Defined testing categories according to their level of complexity and which lab personnel could perform them.

o   Both A and B.

o   None of the above.

QUESTION 16

A patient may enter a hospital in a planned or unplanned manner. A planned entry into the hospital occurs when a physician with admitting privileges refers the patient to that hospital through the admissions office. Remember as a non-clinical healthcare manager you could head up the admissions department. Unplanned patient admissions through the emergency department occur every day e.g. from heart attacks or motor vehicle accidents. The emergency department of a hospital, and how it well it operates, will influence the success of the hospital. For example, if physicians and patients trust the services provided in Hospital A’s ER, it becomes a HUGE source of admissions for hospital A. When beds are full, hospitals are financially healthy. But, if Hospital A’s ER is inefficient – long wait times or patients are misdiagnosed then physicians and patients will go to Hospital B. Hospital B’s admission rates improve and it achieves financial and patient outcome successes.

 

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Psychopathology Through the Eyes of Faith: lotegr^؛!^e Reflections for

t^e Classroom and Beyond

Richard E. Batman

Wheaton College

Mark Yarhouse

Regent University

The Study ofthe Calamities ofthe Soul

We approach the study of psychopathology in these terms: “foe study of the calamities of the soul,” by which we mean that students are learning how to assess, treat, and prevent concerns that affect the whole person, the embodied soul. Stated differently, some- thing is lost in foe study o^ychopathology when we focus only on deviance, dysfunction, danger, or distress (i.e., foe traditional understanding of abnormal behav- ior). Rather, we see foe study o^ychopathology as the emotional and psychological stru^les of persons that affect all dimensions ofhuman beings.

This definition comes from the Greek word for psych ( psukhe)y meaning breath or spirit, suggesting more than just the mind (but including mental pro- cesses), and pathology, su^esting foe scientific study of deviations from a healthy or normal state or condi- tion. Today, it is more common for the scientific study of psychopathology to focus on deviance, dysfunction, danger, and distress (i.e., the “4 Ds” in many contem- porary textbooks). These are certainly important for the conversation, but it seems most appropriate for a faith-based discussion to begin with a broader under- standing of the soul so that we can remind ourselves and our students that we are taking a holistic view of foe person in the service ofthe well-being of the soul.

The definition we have chosen—the study of foe calamities of the soul—has foe potential to offer greater humility and honesty, and a deeper respect for humanity, into our explorations in foe classroom and beyond. To foe traditional emphasis on the 4Ds, we

would Idee to add that ^ychopathology could also be seen as an expression of “disordered desires” or urges and longings that have gone awry.

The Assessment, Treatment and Prevention of M ental Illness

In our approach to teaching ^ychopathology, whether to an audience of undergraduate or graduate and professional-level students, we focus on three key domains: (a) the assessment, classification and diagno- sis of mental illness; (b) the effective treatment of psy- chopathology; and (c) exploring strategies for reducing the intensity, duration or frequency of disordered de- sire (prevention). We want our students to be able to describe the key symptoms ( what isgoingon?)y to offer reasonable explanations for their etiology and mainte- nance (why is this happening?), to be able to explore available treatment options (what might be helpful

– healing and growth}), and to offer creative and in م formed responses to risk reduction in the foture (what might be some preventive options?). Unfortunately, the traditional focus in many psychopathology courses is primarily on learning the Diagnostic and Statisti- cal Manual of Mental Disorders (DSM; APA, 2013) typology regarding foe assessment, classification and diagnosis of mental illness. For us, we strongly advo- cate the need for an “ethical” response (what are the implicationsfor our Christian worldview and lifestyle?). Consequently, we strive to balance solid course content (insight) with a sharp focus on relevant implications for se!want-^a^rioner-scholars (Jones & Butman, 2011).

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PSYCHOPATHOLOGY THROUGH THE EYES OF FAITH

Historical and Contemporary Understanding ofthe Subject Area

In our previous work (Yarhouse, Butman, & McRay, 200s), we noted that there has been a segrega- rion of the soul that took place when the church ab- dicated its responsibilities in working holistically with the soul by having mental concerns addressed solely and exclusively by mental health professionals. There is a rich tradition ofpastoral care and spiritual formation that could deeply inform contemporary discussions. We see some developments in this area with greater emphasis on spiritual Direction today, even to foe ex- tent of specific degree programs. The positive psychol- ogy movement has also offered some helpful insights that compliment these developments. Indeed, psychol ogy, theology, and spiritual formation are all potential contributors to the dialogue (McMinn & Campbell, 2006). In other words, the study of the calamities of foe soul needs to be informed by science and reason (general revelation), scripture and theology (special revelation), foe authority and traditions ofthe church (spiritual formation), and important insights gained from foe narratives (experience) of both practitioners and clients. Finding effective ways to “integrate” these major sources of truth is foe heart ofthe matter for discernment in ^ychopathology (Jones & Butman, 2011).

This discussion comes at a rime in our history in which the mental health fields are in foe midst of sig- nificant turmoil about how best to understand our models of personality, psychopathology, and psycho- therapy. Recent conflicts about classifications systems (Diagnostic and Statistical Manual or DSM, Inter- national Classification of Disease or ICD, Psychody- namic Diagnostic Manual or PDM, and Personality Disorders Institute or PDI) are but one expression of these tensions (APA, 2013). Likewise, fierce de- bates about “best possible practices” {what treatment strategies work best with what types o f persons with what types ofproblems?) often leave the student bewil- dered by perceived chaos and confusion in the field. One of the key tasks ofthe instructor, then, is to help foe student to navigate foe “culture wars” between compering models. The wisdom, knowledge, and compassion so often evident in the history of pastoral care can help us explore the common factors ofeffec- rive treatment like hope, technique, relationships, and contextual or situational variables (McMinn & Camp- bell, 2006). A trend we have bofo noted amongst col- leagues that teach at faith-based institutions, is a grow- ing respect for this literature with each passingyear. As

Deuck and Reimer (2009) have nbserved, “Athens” (the academy) has much to learn from “Jerusalem” (the church).

Integrative k e r n e s in the Subject Area

The Problem ofHuman and Pain (the ^teodicy Debate)

Perhaps the most important theme that must be addressed at the start of a course in psychopathol- ogy is the theodicy debate. Our models of personal- ity, psychopathology, and psychotherapy should be deeply informed by the reality of human brokenness and sinfulness. The sheer statistical reality of the many expressions of serious mental illness (epidemiology) demands enormous sensitivity in this area, w h e n one considers the problems of anxiety and mood—or the problems of personality and psychosis—it would be hard to imagine that any individual in contemporary American society has not been directly or indirectly impacted by human pain and suffering. These themes can be incorporated directly into the content of the course or resources such asJohn Stackhouse’s Can God Be Trusted? or similar introductions to theodicy can be used as an opening reflection/devotional to facilitate discussion.

Specifically, we would recommend that course instructors courageously and carehdly address these concerns from the start of the course. Some form of “affect simulation” seems essential. We have found excellent resources in a wide variety of sources (e.g., articles, books, case studies, and internet) that help stu- dent develop greater awareness of the inner world of mental illness and emotional distress. Helping them to shift from focusing on the differences between them- selves and hurting persons—to exploring the common humanity of the human experience (empathy) seems absolutely critical. If this is not “front-loaded” in the course, the student runs the risk of adopting a more aloof and distant understanding of the reality of the critical mass ofhuman pain and suffering.

The Nature of?ersons (Theological Anthropology)

In our courses in psychopathology, we want our stu- dents to reflect and begin to initially develop a deeper understanding ofwhat it means to be a human being in all its complexities {what makespeople tick?). Specifi- cally, we encourage them to reflect on ways in which the doctrines of creation, the fall, resurrection, and glorification should inform our notions ofpersonhood (Jones & Butman, 2011). At foe most basic level, this

BUTMAN and YARHOUSB

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should mean that every person is created in the image and likeness of God, therefore being of infinite worth and significance (Imago Dei). Likewise, each person is prone to brokenness, deceit, and sin (the utter impos- sibility of human perfection). Finally, there is hope for all persons because ofthe reality of the incarnation and resurrection. The study ofpsychopathology lends itself especially well to “fleshing out” our notions ofbroken- ness and the impact ofboth personal and collective sins of omission and commission (Yarhouse et al., 2005). But even in the midst o f incredible hrokenness, it does not lessen the worth and dignity of each person we en- counter. Practically speaking, this could mean that we have something to learn from each person in every en- counter—if only because they bear the image and like- ness ofGod. Our stance, then, should be one ofincred- ible humility and uncommon decency (Mouw, 2002). Flsewhere, we have tried to make a case for wholistic dualism —a recognition of the fundamental unity of foe mind and body (Jones & Butman, 2011). In short, our students need to understand that “we are not dis- embodied minds—or mindless bodies.” We are fear- fully and wonderfrrlly made in His Image—even in foe midst ofthe most serious expressions of mental illness.

The Nature ofProblems-in-Living (Psychopathology)

Further, we want our students to develop a deeper understanding ofthe etiology and maintenance ofpsy- chopathology. Mental illness is rarely an expression of a single causal factor….