206-2
A patient diagnosed with acquired immune deficiency syndrome (AIDS) is admitted to the acute care floor. Which stance regarding the care for this patient is supported by the American Nurses Association (ANA) Code of Ethics? 1)The nurse is morally obligated to care for the patient unless the risk exceeds responsibility. 2)The nurse has the responsibility to ensure the patient gets adequate medical care. 3)The patient has the right to choose not to disclose his or her condition to staff. 4)The patient is morally bound to disclose every aspect of his or her condition to staff.
1
A patient tells the nurse, "I don't really like the nurse on the first shift; she treats me bad." Which action by the nurse is appropriate in order to advocate for this patient? 1)Call the agency patient advocacy department. 2)Confront the nurse when she comes to work. 3)Tell the patient he or she has the right to switch nurses. 4)Call the local authorities.
1
An adolescent patient diagnosed with leukemia decides to stop chemotherapy treatments. The patient's parents, however, want the health-care team to continue all treatments. Which action by the nurse is appropriate when providing care to this patient and family? 1)Helping the family by providing information and allowing them to voice their concerns 2)Confronting the parents and telling them not to be "selfish" in their child's time of need 3)Calling the authorities immediately 4)Obtaining a court order to determine the patient is legally able to make his or her own decisions
1
The hospice nurse is providing care to a terminal patient who has asked about guidance and support in ending life. Which should the nurse recognize in regards to making an ethical and moral decision in this circumstance? 1)Euthanasia has legal implications along with moral and ethical ones. 2)Passive euthanasia is an easy decision to arrive at. 3)Active euthanasia is supported in the Code for Nurses. 4)Assisted suicide is illegal in all states.
1
The nurse is providing care for a postpartum patient who states, "I know my rights and you have to do what I tell you!" Which response by the nurse is appropriate? 1)"I don't mind doing anything within reason, but you have a responsibility to be considerate to the staff as well." 2)"That statement is not included in your patient rights; don't yell at me." 3)"Why do you feel angry ... did I do something you did not like?" 4)"Do you want me to take the baby to the nursery so you can calm down?"
1
Which ethical principle is the nurse assessing when asking who benefits from the actions of others? 1)Beneficence 2)Autonomy 3)Justice 4)Fidelity
1
Which is the priority nursing action for the ethical decision-making process? 1)Determine exactly what needs to be decided. 2)Formulate alternatives to solve the issue .3)Implement an action to achieve the greatest benefit with the least amount of risk. 4)Ascertain if new information is available regarding the issue.
1
A medical nurse has obtained a new patient's health history and completed the admission assessment. The nurse has followed this by documenting the results and creating a care plan for the patient. Which of the following is the most important rationale for documenting the patient's care? A)It provides continuity of care. B)It creates a teaching log for the family. C)It verifies appropriate staffing levels. D)It keeps the patient fully informed.
A
A nurse uses critical thinking every day when going through the nursing process. Which of the following is an outcome of critical thinking in nursing practice? A)A comprehensive plan of care with a high potential for success B)Identification of the nurse's preferred goals for the patient C)A collaborative basis for assigning care D)Increased cost efficiency in health care
A
An emergency department nurse is caring for a 7-year-old child suspected of having meningitis. The patient is to have a lumbar puncture performed, and the nurse is doing preprocedure teaching with the child and the mother. The nurse's action is an example of which therapeutic communication technique? A)Informing B)Suggesting C)Expectation-setting D)Enlightening
A
From an ethical standpoint, what is the problem with the belief that everyone should receive his or her fair share, that life should always be fair, and that everyone should make his or her own decisions? a.With this belief, the needs of society as a whole are ignored. b.Insufficient resources exist to give everyone a fair share. c.This belief leads to a propensity for some people to like to be taken care of. d.Some people think they deserve more than their fair share.
A
The nurse caring for a patient who is two days post hip replacement notifies the physician that the patient's incision is red around the edges, warm to the touch, and seeping a white liquid with a foul odor. What type of problem is the nurse dealing with? A)Collaborative problem B)Nursing problem C)Medical problem D)Administrative problem
A
The nurse has been measuring the blood pressure of an African-American patient every 4 hours for the past 3 days in a hospital setting. The blood pressure is consistently above 140/90. The patient has been adherent to the antihypertensive drug therapy while hospitalized. The nurse will initially perform which action? a. Determine if the patient has been given high sodium foods from a visitor. b. Withhold the antihypertensive drug until the physician can be notified. c. Increase blood pressure measurements to every 2 hours. d. Place the patient on a restricted fluid intake.
A
The nurse is caring for a patient who is a member of the local Native American community. The patient is refusing medications and treatments in spite of repeated attempts to explain the importance of these interventions. Which is an appropriate nursing action? a. Ask a family member about traditional healing practices that might be better accepted. b. Enlist the help of a family member to explain the need for the medications and treatments. c. Find a hospital staff member who is Native American to help provide teaching for this patient. d. Suggest a Social Work consult to the patient's provider.
A
The nurse is caring for an African-American patient who is taking warfarin (Coumadin) to prevent blood clots. The nurse will monitor this patient carefully for which effect? a. Decreased therapeutic effects b. Heightened risk for hemorrhage c. Increased risk of hypersensitivity d. Potential risk of paradoxical effects
A
The nurse learns that a family has decided not to accept medical intervention for a health care problem because paying for the care would drastically reduce the family's resources and ability to meet the needs of other family members. Ethically, which of the following actions should be taken by the nurse? a.Appreciate that the family has made the decision that it feels is best and take no further action if it is clear the family has made an informed choice. b.Stress that each individual in society has a right to health care and the family will have to create some way to raise funds for the needed treatment. c.Talk to the media to see whether a campaign to raise funds for the family can be created. d.Try to convince the agency to give the care for free, even if it means economic stress for the agency, because the medical need is obvious.
A
When and by whom was nursing's first code of ethics written? a.1893, by Lystra Gretter b.1950, by the ANA House of Delegates c.1953, by the International Council of Nurses (ICN) d.2001, by the ANA House of Delegates
A
Which statement best reflects the physiologic response of individuals of African descent to a drug? a. They are less responsive to beta blockers than are individuals of European descent and Hispanics. b. They are more responsive to beta blockers than are individuals of European descent and Hispanics. c. They experience fewer toxic side effects with psychotropic drugs than do of European descent. d. They experience fewer toxic side effects with antidepressant drugs than do of European descent.
A
While receiving report on a group of patients, the nurse learns that a patient with terminal cancer has granted power of attorney for health care to her brother. How does this affect the course of the patient's care? A)Another individual has been identified to make decisions on behalf of the patient. B)There are binding parameters for care even if the patient changes her mind. C)The named individual is in charge of the patient's finances. D)There is a document delegating custody of children to other than her spouse.
A
You are providing care for a patient who has a diagnosis of pneumonia attributed to Streptococcus pneumonia infection. Which of the following aspects of nursing care would constitute part of the planning phase of the nursing process? A)Achieve SaO2 ≥ 92% at all times. B)Auscultate chest q4h. C)Administer oral fluids q1h and PRN. D)Avoid overexertion at all times.
A
You are the nurse who is caring for a patient with a newly diagnosed allergy to peanuts. Which of the following is an immediate goal that is most relevant to a nursing diagnosis of "deficient knowledge related to appropriate use of an EpiPen"? A)The patient will demonstrate correct injection technique with today's teaching session. B)The patient will closely observe the nurse demonstrating the injection. C)The nurse will teach the patient's family member to administer the injection. D)The patient will return to the clinic within 2 weeks to demonstrate the injection.
A
You are writing a care plan for an 85-year-old patient who has community-acquired pneumonia and you note decreased breath sounds to bilateral lung bases on auscultation. What is the most appropriate nursing diagnosis for this patient? A)Ineffective airway clearance related to tracheobronchial secretions B)Pneumonia related to progression of disease process C)Poor ventilation related to acute lung infection D)Immobility related to fatigue
A
You have just taken report for your shift and you are doing your initial assessment of your patients. One of your patients asks you if an error has been in her medication. You know that an incident report was filed yesterday after a nurse inadvertently missed a scheduled dose of the patient's antibiotic. Which of the following principles would apply if you give an accurate response? A)Veracity B)Confidentiality C)Respect D)Justice
A
Your older adult patient has a diagnosis of rheumatoid arthritis (RA) and has been achieving only modest relief of her symptoms with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). When creating this patient's plan of care, which nursing diagnosis would most likely be appropriate? A)Self-care deficit related to fatigue and joint stiffness B)Ineffective airway clearance related to chronic pain C)Risk for hopelessness related to body image disturbance D)Anxiety related to chronic joint pain
A
A medical nurse is caring for a patient who is palliative following metastasis. The nurse is aware of the need to uphold the ethical principle of beneficence. How can the nurse best exemplify this principle in the care of this patient? A)The nurse tactfully regulates the number and timing of visitors as per the patient's wishes. B)The nurse stays with the patient during his or her death. C)The nurse ensures that all members of the care team are aware of the patient's DNR order. D)The nurse liaises with members of the care team to ensure continuity of care.
B
A new nurse states to a nursing colleague, "But why do I have to be involved in politics? I just want to be the very best clinical nurse I can." Which of the following would be the best response from the nursing colleague? a."As long as you pay your membership fee to the American Nurses Association, you have participated in the profession's political endeavors." b."Political action is the way you try to fulfill your ethical responsibilities to clients." c."You're absolutely right; if you are good clinically, you have fulfilled your obligation." d."When you've completed your clinical orientation, then you'll have time to be involved in politics."
B
A nurse has been offered a position on an obstetric unit and has learned that the unit offers therapeutic abortions, a procedure which contradicts the nurse's personal beliefs. What is the nurse's ethical obligation to these patients? A)The nurse should adhere to professional standards of practice and offer service to these patients. B)The nurse should make the choice to decline this position and pursue a different nursing role. C)The nurse should decline to care for the patients considering abortion. D)The nurse should express alternatives to women considering terminating their pregnancy.
B
A nurse has begun creating a patient's plan of care shortly after the patient's admission. It is important that the wording of the chosen nursing diagnoses falls within the taxonomy of nursing. Which organization is responsible for developing the taxonomy of a nursing diagnosis? A)American Nurses Association (ANA) B)NANDA C)National League for Nursing (NLN) D)Joint Commission
B
A nurse is unsure how best to respond to a patient's vague complaint of "feeling off." The nurse is attempting to apply the principles of critical thinking, including metacognition. How can the nurse best foster metacognition? A)By eliciting input from a variety of trusted colleagues B)By examining the way that she thinks and applies reason C)By evaluating her responses to similar situations in the past D)By thinking about the way that an "ideal" nurse would respond in this situation
B
A nurse provides care on an orthopedic reconstruction unit and is admitting two new patients, both status post knee replacement. What would be the best explanation why their care plans may be different from each other? A) Patients may have different insurers, or one may qualify for Medicare. B) Individual patients are seen as unique and dynamic, with individual needs. C) Nursing care may be coordinated by members of two different health disciplines. D) Patients are viewed as dissimilar according to their attitude toward surgery.
B
An adult patient has requested a "do not resuscitate" (DNR) order in light of his recent diagnosis with late stage pancreatic cancer. The patient's son and daughter-in-law are strongly opposed to the patient's request. What is the primary responsibility of the nurse in this situation? A) Perform a "slow code" until a decision is made. B) Honor the request of the patient. C) Contact a social worker or mediator to intervene. D) Temporarily withhold nursing care until the physician talks to the family.
B
An elderly patient is admitted to your unit with a diagnosis of community-acquired pneumonia. During admission the patient states, "I have a living will." What implication of this should the nurse recognize? A)This document is always honored, regardless of circumstances. B)This document specifies the patient's wishes before hospitalization. C)This document that is binding for the duration of the patient's life. D)This document has been drawn up by the patient's family to determine DNR status.
B
How can nurses know whether they have been effective in assessing the community and planning and implementing appropriate interventions? a.Ask community leaders for their opinion of the interventions. b.Examine the morbidity and mortality rate of the community. c.Reassess the community to determine whether obvious needs have been met. d.Systematically survey community residents regarding their perception
B
In response to a patient's complaint of pain, the nurse administered a PRN dose of hydromorphone (Dilaudid). In what phase of the nursing process will the nurse determine whether this medication has had the desired effect? A)Analysis B)Evaluation C)Assessment D)Data collection
B
The nurse is caring for a patient who is withdrawing from heavy alcohol use and who is consequently combative and confused, despite the administration of benzodiazepines. The patient has a fractured hip that he suffered in a traumatic accident and is trying to get out of bed. What is the most appropriate action for the nurse to take? A)Leave the patient and get help. B)Obtain a physician's order to restrain the patient. C)Read the facility's policy on restraints. D)Order soft restraints from the storeroom.
B
What communication style is characteristic of people of European descent? a. Comfortable with periods of silence b. Maintenance of eye contact c. Use of soft voice d. Use of few words
B
Which of the following is considered the most important goal in nursing today? a.Adapting to technological advances such as electronic medical records b.Demonstrating caring as the basis of nursing practice (caring presence) c.Distinguishing nursing care from medical care d.Seeking evidence-based outcomes to demonstrate nursing's contribution to care
B
While developing the plan of care for a new patient on the unit, the nurse must identify expected outcomes that are appropriate for the new patient. What resource should the nurse prioritize for identifying these appropriate outcomes? A) Community Specific Outcomes Classification (CSO) B)Nursing-Sensitive Outcomes Classification (NOC) C)State Specific Nursing Outcomes Classification (SSNOC) D)Department of Health and Human Services Outcomes Classification (DHHSOC)
B
With which of the following ethical approaches are Gilligan and Noddings associated? a.Distributive justice approach b.Feminine ethic c.Principled approach d.Virtue ethics
B
Achieving adequate pain management for a postoperative patient will require sophisticated critical thinking skills by the nurse. What are the potential benefits of critical thinking in nursing? Select all that apply. A)Enhancing the nurse's clinical decision making B)Identifying the patient's individual preferences C)Planning the best nursing actions to assist the patient D)Increasing the accuracy of the nurse's judgments E)Helping identify the patient's priority needs
ACDE
Which factor(s) may affect a patient's adherence to drug regimens? (Select all that apply) a. Access to health care b. Heredity c. Poverty d. Trust in provider e. Use of same language
ACDE
Three nurses disagree over the appropriate treatment for a woman who is an excellent candidate for hospice care. The first nurse believes that deciding on care rather than cure is the woman's decision and no one else can decide for her. The second nurse says that it is the responsibility of the health care team to do good for the woman, and if the physician thinks there is still a possibility of cure, then the nurses should do everything they can to implement the treatment plan. The third nurse states that it isn't fair for the family members to expend all their resources on the woman, who is probably going to die anyway. Which of the following conclusions can be drawn from this dispute? (Select all that apply.) a.Ethical principles can conflict with one another. b.The nurses are each using different ethical approaches. c.The first nurse is correct because autonomy demands that the woman decide for herself. d.There is no single accepted approach for resolving such disagreements.
AD
The nurse admits a patient to an oncology unit that is a site for a study on the efficacy of a new chemotherapeutic drug. The patient knows that placebos are going to be used for some participants in the study but does not know that he is receiving a placebo. When is it ethically acceptable to use placebos? A)Whenever the potential benefits of a study are applicable to the larger population B)When the patient is unaware of it and it is deemed unlikely that it would cause harm C)Whenever the placebo replaces an active drug D) When the patient knows placebos are being used and is involved in the decision-making process
D
The nurse is caring for a postoperative patient who is of Asian descent. The patient reports little relief from pain even while taking an opioid analgesic containing codeine and acetaminophen. What does the nurse suspect that this patient is exhibiting? a. Drug-seeking behavior b. Heightened pain perception c. Poor understanding of expected drug effects d. Rapid metabolism of one of the drug's components
D
The nurse is performing a health assessment on a newly admitted patient of Asian descent. The patient looks at the floor whenever the nurse asks a question. Communication is enhanced when the nurse does which action? a. Frequently touches the patient. b. Asks questions that require only a "yes" or "no" c. Discontinues the health assessment. d. Uses eye contact sparingly
D
The nurse is providing care for a patient with chronic obstructive pulmonary disease (COPD). The nurse's most recent assessment reveals an SaO2 of 89%. The nurse is aware that part of critical thinking is determining the significance of data that have been gathered. What characteristic of critical thinking is used in determining the best response to this assessment finding? A)Extrapolation B)Inference C)Characterization D)Interpretation
D
The nurse notes that a patient of African American descent who is taking an oral antihypertensive medication continues to have elevated blood pressure three months after beginning the medication regimen. The nurse suspects that the patient may be a. consuming ethnic foods that interfere with absorption of the drug. b. discarding the medication. c. experiencing allergic reactions to the medication. d. metabolizing the drug differently than expected.
D
The nursing instructor is explaining critical thinking to a class of first-semester nursing students. When promoting critical thinking skills in these students, the instructor should encourage them to do which of the following actions? A)Disregard input from people who do not have to make the particular decision. B)Set aside all prejudices and personal experiences when making decisions. C)Weigh each of the potential negative outcomes in a situation. D)Examine and analyze all available information
D
The older adult patient is newly diagnosed with diabetes and has been prescribed metformin. The patient's healer has recommended that the patient drink sabila tea three times per day to improve nutrition and help control blood sugar level. What is the nurse's best action? a. Encourage the patient to drink the tea four times per day instead. b. Discourage the practice because sabila tea potentiates metformin. c. Tell the patient to stop the tea immediately. d. Advise the patient he can continue to drink the tea but he also needs to continue his drugs
D
The physician has recommended an amniocentesis for an 18-year-old primiparous woman. The patient is 34 weeks' gestation and does not want this procedure. The physician is insistent the patient have the procedure. The physician arranges for the amniocentesis to be performed. The nurse should recognize that the physician is in violation of what ethical principle? A)Veracity B)Beneficence C)Nonmaleficence D)Autonomy
D
Which of the following is the dominant issue in ethical debate around an issue such as continuing or withdrawing treatment in acute health care? a.Doing what is best for the community b.Doing what is best for the family c.Obeying legal mandates d.Upholding ethical principles
D
Which of the following would confirm that the nurse's advocacy has been truly successful or effective? a.Audiences agree with the nurse who is serving as advocate. b.Legislators discuss appropriate legislation to better allocate resources. c.People verbalize that the disenfranchised should be better treated. d.Systematic social changes are made to improve quality of life.
D
You are following the care plan that was created for a patient newly admitted to your unit. Which of the following aspects of the care plan would be considered a nursing implementation? A)The patient will express an understanding of her diagnosis. B)The patient appears diaphoretic. C)The patient is at risk for aspiration. D)Ambulate the patient twice per day with partial assistance
D
The nurse is providing care to a client who is considered brain dead. The family has opted to end care and the health-care provider asks the nurse to pull the endotracheal (ET) tube. The nurse is uncomfortable with this request. Which is the reason the nurse is experiencing difficulty with this task? 1)An ethical conflict 2)Personal values 3)Legal issues 4)A cultural conflict
2
The nurse is providing care to an older adult patient with terminal cancer who has opted to discontinue treatment and go home. The patient's family, however, wants to continue treatment. The nurse agrees to be present while the patient tells the family. Which ethical patient principle is the nurse supporting? 1)Beneficence 2)Autonomy 3)Nonmaleficence 4)Justice
2
Which statement best describes the American Nurses Association (ANA) Code of Ethics for professional nurses? 1)"It alleviates suffering for those cared for by professional nurses." 2)"It provides standards for professional nursing practice." 3)"It reflects legal judgments in professional nursing practice." 4)"It serves as legal standards for professional nursing practice."
2
Which statement regarding the American Nurses Association (ANA) Code of Ethics for professional nurses is accurate? 1)"It is used by all health-care professionals." 2)"It guides nurses in their professional behavior and relationships." 3)"It forms the basis for possible lawsuits." 4)"It is the only code of ethics available for nurses."
2
A patient is diagnosed with a sexually transmitted infections (STI) and states to the nurse, "Promise you will not tell anyone about my condition." Which action should the nurse take, when considering the Health Insurance Portability and Accountability Act (HIPAA) of 1996? 1)Honor the patient's wishes 2)Respect the patient's privacy and confidentiality. 3)Communicate only necessary information. 4)Not disclosing any information to anyone.
3
The nurse is providing care to a 3-year-old child whose parents decide to decline further treatment for cancer, which has metastasized. There is a conflict between the child's parents and the rest of the family. Which should the nurse consider when determining the appropriate action for this patient? 1)The age of the child 2)The beliefs of the child 3)The values of the parents 4)The values of the rest of the family
3
The nurse is providing care to a patient who states, "My doctor is refusing to treat me because I am noncompliant with his recommendations." Which is the priority nursing action in this situation? 1)Have the patient contact a consumer agency. 2)Advise the patient to sue the health-care provider. 3)Take the patient's issue to the hospital ethics committee. 4)Notify the health-care provider of the patient's complaints.
3
The nurse is providing care to an older adult patient who has decided to discontinue the prescribed hemodialysis. The patient's family, however, is not supportive of this decision. When using the theory of principles-based reasoning, which statement from the nurse is appropriate? 1)"The patient understands the decision and the advanced stage of the disease. If the patient quits treatment, the patient will die." 2)"I need to try to help the family understand the patient's decision so they can work through this situation together." 3)"This patient is of sound mind and is capable of making independent decisions regarding health care. It really is the patient's decision to make." 4)"This patient's health is so deteriorated that the treatment is not saving the patient's life. It is prolonging the ultimate outcome, which is death."
3
Which action is appropriate when dealing with an ethical dilemma in practice? 1)Relying on nursing judgment 2)Examining all conflicts in the situation 3)Investigating all aspects of the situation 4)Making a decision based on the policy of the agency
3
Which number of alternative solutions should be included when conducting ethical decision-making? 1)One 2)Two 3)Three 4)Four
3
The nurse is providing care to an older adult patient who is scheduled for surgery. During the preoperative assessment, the nurse discovers that the patient does not have an adequate understanding of the procedure. Which is the reason for the nurse to take action in this situation? 1)The patient is very old and has multiple health problems. 2)The family needs to agree to the surgery. 3)The nurse witnessed the consent. 4)The patient has a right to informed consent.
4
Which ethical principle requires the nurse to be accountable for commitments made to self or others? 1)Beneficence 2)Autonomy 3)Justice 4)Fidelity
4
Which professional value is the nurse demonstrating by volunteering time to work in a local free clinic? 1)Human dignity 2)Integrity 3)Altruism 4)Social justice
4
A group of students have been challenged to prioritize ethical practice when working with a marginalized population. How should the students best understand the concept of ethics? A)The formal, systematic study of moral beliefs B)The informal study of patterns of ideal behavior C)The adherence to culturally rooted, behavioral norms D)The adherence to informal personal values
A
Which factor(s) may affect a patient's physiologic responses to drugs? ( Select all that apply) a. Age b. Diet c. Language d. Genetics e. Values
ABD
A male nurse is caring for a young married observant Muslim. It is important that the nurse initially perform which action? a. Delay any care that requires touching until a female nurse is available. b. Identify the patient's preference regarding touch. c. Touch the patient only when her spouse is present. d. Inform the patient that she must allow him to touch her.
B
A Native American patient has just been diagnosed with diabetes mellitus. The nurse preparing a teaching plan for this patient understands that which aspect of the disease and disease management may be most difficult for this patient? a. Body image changes b. Management of meal and medication schedules c. Perception of the disease as punishment from God d. The sense of dependence on others
B
A class of nursing students is in their first semester of nursing school. The instructor explains that one of the changes they will undergo while in nursing school is learning to "think like a nurse." What is the most current model of this thinking process? A)Critical-thinking Model B)Nursing Process Model C)Clinical Judgment Model D)Active Practice Model
C
A Native American patient is newly diagnosed with diabetes mellitus type 2 and is prescribed the antidiabetic drug metformin 500 mg per os with morning and evening meals. Which statement best indicates to the nurse that the patient will adhere to the pharmacotherapy? a. I will be healthier if I don't eat sugar anymore. b. When I feel better, I won't have to take this medicine. c. I must take the medicine as scheduled to prevent damage to my body. d. I have diabetes because of my ancestry, so there's not much I can do about it.
C
The nurse has just taken report on a newly admitted patient who is a 15-year-old girl who is a recent immigrant to the United States. When planning interventions for this patient, the nurse knows the interventions must be which of the following? Select all that apply. A)Appropriate to the nurse's preferences B)Appropriate to the patient's age C)Ethical D)Appropriate to the patient's culture E)Applicable to others with the same diagnosis
BCD
The nursing instructor cites a list of skills that support critical thinking in clinical situations. The nurse should describe skills in which of the following domains? Select all that apply. A)Self-esteem B)Self-regulation C)Inference D)Autonomy E)Interpretation
BCE
A man entered the emergency department bleeding profusely and screaming, "I've got to see a doctor right now! I've got a right to see a doctor! I'm hurt. You have to take care of me!" Which of the following premises would ethically justify such a demand for immediate attention? a.All hospitals receive federal money and all capable employed adults pay taxes, so all adults have a right to what their tax money has purchased. b.Saving an individual's life improves society and upholds tradition. c.Our society believes that all persons should be treated equally and that basic needs, such as not dying if death can be avoided, should be met. d.The man has a property right to his own body, and the government is responsible to ensure that property rights are protected.
C
A nurse didn't know what to do when faced with a particular ethical dilemma because an option that would have a good outcome didn't seem possible. The nurse decided to talk to the agency supervisor and decide what action to take. Which of the following best describes the nurse's actions? a.Appropriate, because the supervisor is responsible for the nurse's choices b.Intelligent, because the supervisor has access to resource persons (clergy, physicians, administrators) who might know of options the nurse hadn't considered c.Justified, because this provides an opportunity to discuss the issue but the nurse maintains responsibility for the decision d.Wise, because the supervisor would be more knowledgeable concerning agency priorities and traditional practices
C
A nurse has been providing ethical care for many years and is aware of the need to maintain the ethical principle of nonmaleficence. Which of the following actions would be considered a contradiction of this principle? A)Discussing a DNR order with a terminally ill patient B)Assisting a semi-independent patient with ADLs C)Refusing to administer pain medication as ordered D)Providing more care for one patient than for another
C
A nurse is teaching a 16-year old patient about a newly prescribed medication. The patient is bilingual in Spanish and English. Which behavior best indicates the patient's understanding of the instructions? a. The patient frequently nods her head while listening to the nurse's instructions. b. The patient states that she understands the instructions. c. The patient repeats the nurse's instructions to her parents. d. The patient does not ask the nurse for clarification of the instructions.
C
A patient has been diagnosed with small-cell lung cancer. He has met with the oncologist and is now weighing the relative risks and benefits of chemotherapy and radiotherapy as his treatment. This patient is demonstrating which ethical principle in making his decision? A)Beneficence B)Confidentiality C)Autonomy D)Justice
C
A patient who is of Filipino descent is admitted to the hospital. The nurse goes to the room to start intravenous fluids and to perform an admission assessment and finds several family members in the room. Which action by the nurse is appropriate? a. Ask the family to wait in the hallway until the admission tasks are completed. b. Determine which family member is the family patriarch and address questions to him. c. Invite family members to assist with appropriate tasks during the admission process. d. Provide chairs for family members and ask them to stay seated during the admission
C
A patient with migraines does not know whether she is receiving a placebo for pain management or the new drug that is undergoing clinical trials. Upon discussing the patient's distress, it becomes evident to the nurse that the patient did not fully understand the informed consent document that she signed. Which ethical principle is most likely involved in this situation? A)Sanctity of life B)Confidentiality C)Veracity D)Fidelity
C
A recent nursing graduate is aware of the differences between nursing actions that are independent and nursing actions that are interdependent. A nurse performs an interdependent nursing intervention when performing which of the following actions? A)Auscultating a patient's apical heart rate during an admission assessment B)Providing mouth care to a patient who is unconscious following a cerebrovascular accident C)Administering an IV bolus of normal saline to a patient with hypotension D)Providing discharge teaching to a postsurgical patient about the rationale for a course of oral antibiotics
C
A terminally ill patient you are caring for is complaining of pain. The physician has ordered a large dose of intravenous opioids by continuous infusion. You know that one of the adverse effects of this medicine is respiratory depression. When you assess your patient's respiratory status, you find that the rate has decreased from 16 breaths per minute to 10 breaths per minute. What action should you take? A)Decrease the rate of IV infusion. B)Stimulate the patient in order to increase respiratory rate. C)Report the decreased respiratory rate to the physician. D)Allow the patient to rest comfortably.
C
An audit of a large, university medical center reveals that four patients in the hospital have current orders for restraints. You know that restraints are an intervention of last resort, and that it is inappropriate to apply restraints to which of the following patients? A)A postlaryngectomy patient who is attempting to pull out his tracheostomy tube B)A patient in hypovolemic shock trying to remove the dressing over his central venous catheter C) A patient with urosepsis who is ringing the call bell incessantly to use the bedside commode D) A patient with depression who has just tried to commit suicide and whose medications are not achieving adequate symptom control
C
During discussion with the patient and the patient's husband, you discover that the patient has a living will. How does the presence of a living will influence the patient's care? A)The patient is legally unable to refuse basic life support. B)The physician can override the patient's desires for treatment if desires are not evidence-based. C)The patient may nullify the living will during her hospitalization if she chooses to do so. D)Power-of-attorney may change while the patient is hospitalized.
C
How are ethics and public policies similar? 🡪 focus on public good a.Both are abstract principles that often differ in actual practice. b.Both are best achieved by persons in high political office who can effect change. c.Both strive for the public good. d.Both use general principles in making decisions.
C
In the process of planning a patient's care, the nurse has identified a nursing diagnosis of Ineffective Health Maintenance related to alcohol use. What must precede the determination of this nursing diagnosis? A)Establishment of a plan to address the underlying problem B)Assigning a positive value to each consequence of the diagnosis C)Collecting and analyzing data that corroborates the diagnosis D)Evaluating the patient's chances of recovery
C
Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "But it doesn't have to be an either/or situation. Perhaps each family member could take a turn calling in sick just 2 or 3 days. That way they could all take a turn at helping and yet not upset their employers. Wouldn't that be fair?" Which of the following ethical approaches is being used by this nurse? a.Communitarianism b.Deontological ethics c.Principlism d.Utilitarianism
C
Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "It's not up to us; it's the family's decision. They know what is best for them." Which of the following ethical approaches is being used by this nurse? a.Communitarianism b.Deontological ethics c.Principlism d.Utilitarianism
C
Some nurses are debating about the appropriate action to take in relation to a particular family. The father is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "It is a wife's responsibility to care for an ill husband." Which of the following ethical approaches is being used by this nurse? a.Consequentialism b.Communitarianism c.Deontological ethics d.Principlism
C
The care team has deemed the occasional use of restraints necessary in the care of a patient with Alzheimer's disease. What ethical violation is most often posed when using restraints in a long-term care setting? A)It limits the patient's personal safety. B)It exacerbates the patient's disease process. C)It threatens the patient's autonomy. D)It is not normally legal.
C
The nurse is caring for an African-American patient who appears to understand instructions for self-care but does not carry out basic self-care tasks. The nurse understands that the patient may a. be poorly educated and lack basic comprehension skills. b. need more time and personal space to assimilate what is taught. c. require the use of culturally appropriate words and phrases when teaching. d. view illness as punishment and lack desire to change the outcome.
C
The nurse is performing a pain assessment on a patient of Asian descent. The patient does not describe the pain when asked to do so and looks away from the nurse. What will the nurse do next? a. Ask the patient's family member to evaluate the patient's pain. b. Conclude that the patient's pain is minimal. c. Evaluate the patient's non-verbal pain cues. d. Suspect that the patient is experiencing severe pain.
C
The nurse is preparing to discuss long-term care needs with a patient newly diagnosed with a chronic disease. The patient is of Latin American descent. The nurse will plan to take which action when teaching this patient? a. Discussing long-term outcomes associated with compliance of the prescribed regimen b. Highlighting various traditional healing practices that will not be effective for this patient's care c. Providing factual information and answering all questions as they arise d. Providing teaching in increments, allowing periods of silence to allow assimilation of information
C
The nurse, in collaboration with the patient's family, is determining priorities related to the care of the patient. The nurse explains that it is important to consider the urgency of specific problems when setting priorities. What provides the best framework for prioritizing patient problems? A)Availability of hospital resources B)Family member statements C)Maslow's hierarchy of needs D)The nurse's skill set
C
The patient who is Jamaican is currently 4 months pregnant and informs the nurse during a prenatal visit that she eats red clay to provide nutrients to the fetus. She states that this is a practice her grandmother told her would ensure a healthy pregnancy. What is the best action by the nurse? a. Contact Child Protective Services. b. Insist that the patient stop the practice immediately. c. Determine the amount of clay she eats daily. d. Discuss the research about dietary intake of clay.
C
The staff cannot reach an agreement on what is the right thing to do in relation to a specific patient. Which of the following approaches should the nurse use in personally deciding what is right? a.Do whatever will not get the nurse in trouble with employer b.Do whatever is supported by an ethical expert, such as the hospital chaplain c.Do whatever the nurse would recommend to anyone in a similar situation d.Do whatever the nurse supervisor would feel comfortable reporting to administration
C
What is the relationship between ethics and a community health nursing practice? a.Ethics and actual nursing practice are not related. b.Knowing ethics allows nurse to recognize the source of most problems. c.Ethics is constantly involved in nurses' clinical decisions. d.Although ethics is important, political and legal responsibilities are more important in practice.
C
Which ethnic or cultural group may experience decreased effects of codeine? a. African Americans b. Latin American descent c. Asian descent d. Native American descent
C
Which of the following is the first and most crucial step in the ethical decision-making process? a.Assess the context or environment in which the decision must be made. b.Consider the various ethical principles or theories. c.Identify the ethical concerns. d.Make a decision and act on it.
C
Your patient has been admitted for a liver biopsy because the physician believes the patient may have liver cancer. T he family has told both you and the physician that if the patient is terminal, the family does not want the patient to know. The biopsy results are positive for an aggressive form of liver cancer and the patient asks you repeatedly what the results of the biopsy show. What strategy can you use to give ethical care to this patient? A)Obtain the results of the biopsy and provide them to the patient. B)Tell the patient that only the physician knows the results of the biopsy. C)Promptly communicate the patient's request for information to the family and the physician. D) Tell the patient that the biopsy results are not back yet in order temporarily to appease him
C
Critical thinking and decision-making skills are essential parts of nursing in all venues. What are examples of the use of critical thinking in the venue of genetics-related nursing? Select all that apply. A)Notifying individuals and family members of the results of genetic testing B)Providing a written report on genetic testing to an insurance company C)Assessing and analyzing family history data for genetic risk factors D)Identifying individuals and families in need of referral for genetic testing E)Ensuring privacy and confidentiality of genetic information
CDE
A care conference has been organized for a patient with complex medical and psychosocial needs. When applying the principles of critical thinking to this patient's care planning, the nurse should most exemplify what characteristic? A)Willingness to observe behaviors B)A desire to utilize the nursing scope of practice fully C)An ability to base decisions on what has happened in the past D)Openness to various viewpoints
D
A nurse has been using the nursing process as a framework for planning and providing patient care. What action would the nurse do during the evaluation phase of the nursing process? A)Have a patient provide input on the quality of care received. B)Remove a patient's surgical staples on the scheduled postoperative day. C)Provide information on a follow-up appointment for a postoperative patient. D)Document a patient's improved air entry with incentive spirometric use.
D
A nurse is admitting a new patient to the medical unit. During the initial nursing assessment, the nurse has asked many supplementary open-ended questions while gathering information about the new patient. What is the nurse achieving through this approach? A)Interpreting what the patient has said B)Evaluating what the patient has said C)Assessing what the patient has said D)Validating what the patient has said
D
A nurse is asked to meet with a family who recently emigrated from Botswana (Africa). After the clinical doctor tells the husband the wife's diagnosis of breast cancer, the family thanks the physician and starts to leave. Ethically, which of the following is the nurse's most important action? a.Emphasizing that the family must set up a surgical appointment for the wife immediately b.Assessing the family's current living situation, including insurance and other assets c.Educating the family concerning the usual treatment and the prognosis of breast cancer d.Interviewing the family concerning their perspective of the threat to the family's well-being
D
A patient admitted with right leg thrombophlebitis is to be discharged from an acute-care facility. Following treatment with a heparin infusion, the nurse notes that the patient's leg is pain-free, without redness or edema. Which step of the nursing process does this reflect? A)Diagnosis B)Analysis C)Implementation D)Evaluation
D
A physician refuses to order pain medication for a drug addict who has been severely injured in a car accident. When reminded by nurses that pain medication has not been ordered, the physician merely replies that the patient's suffering from the pain of his injuries will build character and that the addicted patient needs to get off drugs. Which of the following ethical theories is the physician using (or misusing)? a.Consequentialism b.Communitarianism c.Deontological ethics d.Virtue ethics - reasoning
D
A student nurse has been assigned to provide basic care for a 58-year-old man with a diagnosis of AIDS-related pneumonia. The student tells the instructor that she is unwilling to care for this patient. What key component of critical thinking is most likely missing from this student's practice? A)Compliance with direction B)Respect for authority C)Analyzing information and situations D)Withholding judgment
D
During report, a nurse finds that she has been assigned to care for a patient admitted with an opportunistic infection secondary to AIDS. The nurse informs the clinical nurse leader that she is refusing to care for him because he has AIDS. The nurse has an obligation to this patient under which legal premise? A)Good Samaritan Act B)Nursing Interventions Classification (NIC) C)Patient Self-Determination Act D)ANA Code of Ethics
D
Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "The whole family is being affected and will fall apart if they don't focus on their family's needs first before anything else." Which of the following ethical approaches is being used by this nurse? a.Communitarianism b.Deontological ethics c.Principlism d.Utilitarianism
D