Answer to Question 1
A
Critical thinking requires reflection on what occurred, how data were processed, and how decisions were made. Journaling is one method of developing critical thinking skills.
Journaling does give nurses time to review what happened in their clinical, but this statement does not go far enough in explaining the importance of the journal-writing process.
Journaling may be a way to organize thoughts about one's experiences, but this statement is too narrow an explanation and does not account for the critical aspect of reflection.
Open-mindedness is a critical thinking disposition that allows one to be tolerant of divergent views. Journaling can assist with developing this disposition but only if what is written reflects that specific topic.
Answer to Question 2
C
The provisions of the Affordable Care Act encourage quality improvement through the development of reliable quality measurements and enforcing accountability. Specifically, the Act reduces payments to hospitals with 25th percentile or higher rate of hospital-acquired infections. To avoid losing that money and to show quality, the DON would implement policies that are designed to prevent hospital-acquired infections. Monopsony is the practice of hospitals setting nurses' wages to maximize profits. This does not ensure quality. Hiring more nonprofessional staff may save money but does not improve quality. Purchasing capital budget items only when necessary may be a sound financial strategy but may have a deleterious effect on quality. The only option to both improve profit and quality is to prevent hospital-acquired infections.