5, 6, & 7 Concepts 1

The nurse is participating in a discussion about controlled substances. Which statement, made by the nurse, indicates the nurse is aware of laws governing the distribution of controlled substances?

"Nurses are responsible for adhering to specific documentation about controlled substances." (Nurses have specific responsibilities regarding controlled substances, including specific documentation. Violation of controlled substances at the workplace is serious and is considered a criminal act. Substance abuse is treatable and the objective is to detect and treat the problem early. It does not matter where the nurse obtains the drugs; she is still liable for her actions.)

The nurse fails to contact the physician regarding a client who had an open-reduction internal fixation of the tibia and has experienced increasing leg pain (unrelieved by pain medication) for the past four hours. Which element of liability has been violated? a) Duty b) Damages c) Causation d) Breach of duty

Breach of duty (Failure to contact the physician and report the client's condition does not meet the expected standard of care and is a breach of duty. Duty refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse-client relationship. Causation shows that the failure to meet the standard of care actually caused injury. Damages are the actual harm or injury to the client.)

A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse? a) If a mistake was made on a chart, change it to read appropriately. b) Be prepared to tell your side to the press, if necessary. c) Discuss the case with the plaintiff to ensure understanding of each other's positions. d) Do not volunteer any information on the witness stan

Do not volunteer any information on the witness stand. (The nurse on the witness stand should be polite, but not volunteer any information. The nurse should only answer the questions asked. The other examples are not examples of what a nurse should do in a malpractice lawsuit.)

A nursing student administers an overdose of a narcotic to a client and the client arrests. When discussing the incident with nursing faculty, which statements, if made by the student, indicate the need for further teaching?

• "I am glad I am a student because nursing faculty will be blamed, not me." • "I cannot be held liable because this is only my second time at this facility.

The nurse attorney provides an educational session to the nursing staff on acts of negligence. Which responses by the staff would indicate to the attorney that the staff can accurately identify acts of negligence? Select all that apply. a) "When I am using a new piece of equipment for the first time, I must make sure I know how to properly operate it." b) "I can be charged with negligence if I am following the standards of care for my specialty, which is ambulatory nursing." c) "I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a first-degree burn." d) "I can be charged with negligence if I notify the heath care practitioner about a change in a client's status, but am unable to reach him and do not follow up or document." e) "I can be charged with negligence if I follow the policy for administering insulin and the client has a reaction to it."

• "I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a first-degree burn." • "I can be charged with negligence if I notify the heath care practitioner about a change in a client's status, but am unable to reach him and do not follow up or document." (Negligence occurs when a nurse fails to provide care that another nurse with the same educational background would perform. Applying heat and burning the client's skin is not an act another prudent nurse would do.)

Which of the following questions should the nurse include in a cultural assessment? Select all that apply. a) "What do you think about religions other than yours?" b) "What religion do you belong to?" c) "What do you think is causing your illness?" d) "What do you do to promote good health?" e) "Do have a particular name for this illness?"

• "What do you think is causing your illness?" • "What religion do you belong to?" • "What do you do to promote good health?" • "Do have a particular name for this illness?" ( Trans-cultural assessment encompasses a number of considerations surrounding illness, such as causation, naming, prevention, and health promotion. As well, it is significant and appropriate to ask what religion or religious group a patient identifies with. However, it is likely unnecessary and possibly inappropriate to elicit the patient's views of those who belong to other religious groups.)

A school nurse interviewing parents of a child who is doing poorly in school determines that the parents practice a laissez-faire method of discipline. What are examples of this form of value transmission? (Select all that apply.)

• A teenage boy explores religions of friends in hopes of developing his own faith. • A teenage girl tries alcohol at a party with her friends

A Muslim client is admitted to the hospital. What cultural considerations might the nurse include in the plan of care? (Select all that apply.) a) Provide a diet that is rich in all types of protein. b) Note that Muslims fast from sunrise to sunset. c) Assign care providers of the same sex. d) Avoid touching clients of the opposite sex. e) Make accommodations for the prayer needs of the client.

• Assign care providers of the same sex. • Avoid touching clients of the opposite sex. • Make accommodations for the prayer needs of the client. (A Halal diet that is free of pork or pork products is appropriate. Muslims fast from sunrise to sunset only during Ramadan. )

A nurse considers the culture of an Appalachian female patient when counseling her about contraceptives. Which beliefs are consistent with this culture? (Select all that apply.) a) Illness is considered a punishment from God. b) Feelings about losses or death may be fatalistic. c) Independence and self-determination are valued. d) Youth is valued over age. e) Isolation is an accepted way of life. f) Belief is in a divine existence rather than attending a particular church.

• Belief is in a divine existence rather than attending a particular church. • Isolation is an accepted way of life. • Feelings about losses or death may be fatalistic. • Independence and self-determination are valued.

How is the nursing profession becoming more culturally diverse? Select all that apply. a) By the increased number of foreign-born nurses in the profession b) Through meeting admission quotas for Hispanic nursing students c) By admitting a required number of foreign-born nursing students d) Through meeting the mission of Sigma Theta Tau International e) By the increased number of male nurses in the profession

• By the increased number of foreign-born nurses in the profession • By the increased number of male nurses in the profession. (The increase in numbers of foreign-born nurses reflects a comparable growth in the size of the foreign-born populations of the country, by some 11 million between the censuses of 1990 and 2000. Cultural diversity is also achieved by the increased number of males in the profession compared to the predominantly female work force in the past.)

Which of the following examples are considered acceptable cultural norms in health care? (Select all that apply.) a) Defining diabetes mellitus as a metabolic disorder characterized by elevated blood sugar b) Documenting pain with every client assessment c) Arriving late for a scheduled appointment d) Encouraging adult women to conduct self-breast exams once a month e) Following a specific regimen for cardiac rehab

• Defining diabetes mellitus as a metabolic disorder characterized by elevated blood sugar • Documenting pain with every client assessment • Encouraging adult women to conduct self-breast exams once a month • Following a specific regimen for cardiac rehab

Transcultural nursing is a specialty and formal area of practice. Which statement(s) applies Dr. Madeline Leininger's theory of Cultural Care and Diversity and Universality to nursing practice? (Select all that apply.) a) The nurse consults clergy for assistance in the provision of care. b) The nurse should use curiosity and ethnocentrism when assessing the client's cultural practices. c) The nurse explains how culture does not affect the overall plan of care. d) The nurse will accommodate cultural dietary preferences as much as possible. e) The nurse carefully assesses the decision maker in the care environment. f) The nurse objectively assesses personal beliefs prior to the provision of culturally competent care.

• The nurse objectively assesses personal beliefs prior to the provision of culturally competent care. • The nurse consults clergy for assistance in the provision of care. • The nurse carefully assesses the decision maker in the care environment. • The nurse will accommodate cultural dietary preferences as much as possible. (Cultural competence takes time. It involves developing awareness, acquiring knowledge, and practicing skills. This includes objectively assessing personal beliefs, consulting clergy, and assessing familial roles and dietary preferences. When assessing cultural practices, using genuine interest is appropriate versus curiosity with the tone of cultural superiority (ethnocentrism). Culture should be a part of the care plan.)