Final Exam Questions
In vitro fertilization-embryo transfer (IVF-ET) is a common approach for women with blocked fallopian tubes or unexplained infertility and for men with very low sperm counts. A husband and wife have arrived for their preprocedural interview. The husband asks the nurse to explain what the procedure entails. The nurse's most appropriate response is: a. "IVF is a type of assisted reproductive therapy that involves collecting eggs from your wife's ovaries, fertilizing them in the lab with your sperm, and transferring the embryo to her uterus." b. "A donor embryo will be transferred into your wife's uterus." c. "Donor sperm will be used to inseminate your wife." d. "Don't worry about the technical stuff; that's what we are here for."
"IVF is a type of assisted reproductive therapy that involves collecting eggs from your wife's ovaries, fertilizing them in the lab with your sperm, and transferring the embryo to her uterus
A 70-year-old woman has been admitted to the hospital for a surgical procedure. During the admission process, the patient asks, "What is a living will?" the best response by the nurse would be which of the follow? a."A living will and a durable power of attorney are both advanced directives" b."A living will states your wishes regarding future healthcare if you become unable to give instructions" c."A living will identifies a person who will make healthcare decisions in the event you are unable to do so" d."I will tell a case manager that you would like additional information"
."A living will states your wishes regarding future healthcare if you become unable to give instructions"
With regard to the assessment of female, male, and couple infertility, nurses should be aware that: a.The couple's religious, cultural, and ethnic backgrounds provide emotional clutter that does not affect the clinical scientific diagnosis. b.The investigation takes 3 to 4 months and a lot of money. c.The woman is assessed first; if she is not the problem, the male partner is analyzed. d.Semen analysis is for men; the postcoital test is for women.
.The investigation takes 3 to 4 months and a lot of money.
Based on our groups' viewpoint of "sickest first," which patient should the RN see first after receiving report? a) 56 year-old male one day after an appendectomy with stable vitals and serosanguinous fluid draining from surgical site b) 4 year-old female admitted to the unit after swallowing a marble with no abdominal pain or blood stools present c) 35 year-old female admitted to the unit after a cardiac catheterization with sudden complaint of chest pain, diaphoresis, and elevated blood pressure d) An 84 year-old man who sustained a fall one week ago and is to be discharged later today
35 year-old female admitted to the unit after a cardiac catheterization with sudden complaint of chest pain, diaphoresis, and elevated blood pressure
Which patient would be medically excluded from receiving the Varicella vaccination? A 6 year old child whose mother believes vaccinations causes autism A 15 month old who had redness at the injection site after his last vaccination A 23 year old immunocompromised patient A 4 year old girl whose parents do not want to vaccinate based on religious beliefs
A 23 year old immunocompromised patient
As the nurse it is important to know what informed consent is to be able to advocate for your patients. Which of the following would the nurse identify as a definition for informed consent A.Permission granted in the knowledge of the possible consequences by the patient B.The patient's ability to be able to be able to participate in care C.The patient's family working with the physician to obtain ultimate health D.Permission For the doctor to do what they want when caring for the patient
A.Permission granted in the knowledge of the possible consequences by the patient
Which of the following is not a type of abortion? a. Spontaneous b. Elective c. Incomplete d. Abrupt
Abrupt
A nurse practices beneficence when educating a patient about the risks and benefits of their medication. Beneficence can be described as: Telling the truth The right to self determination Actions that promote good Doing no harm
Actions that promote good
Assisted suicide is expressly prohibited under statuary or common law in the overwhelming majority of states. Yet public support for physician-assisted suicide has resulted in a number of state ballot initiatives. The issue of assisted suicide is opposed by nursing and medical organizations as a violation of the ethical traditions of nursing and medicine. Which of the following would be an example of assisted suicide? a) Neglecting to resuscitate a client with a "do not resuscitate" status b) Administering a lethal dose of medication c) Granting a client's request not to initiate enteral feeding when the client is unable to eat d) Administering a morphine infusion
Administering a lethal dose of medication
What legal documentation displays that a person is an organ donor? (Select all that apply.) a) Advance Directive b) Health Care Proxy c) Donor Card d) Informed Consent
Advance Directive Donor Card
What is the document that lists the medical treatment a person has chosen to refuse if they are unable to make decisions for themself? Advance directive Informed consent Living will Durable power of attorney
Advance directive
A nurse informs the patient's health care provider that the patient is refusing potentially life saving surgery. In this situation, which ethical principle is the nurse using? a)Beneficence b)Nonmaleficence c)Autonomy d)Justice
Autonomy Rationale: Autonomy is the state or condition of self-governance, or leading to one's life according to reasons, values, or desires that are authentically one's own. In this situation, the patient is refusing a surgery, based on their own beliefs, and making the medical decision on what they feel is best. This is practicing the ethical principle of autonomy.
Physician assisted death allows a patient to practice their: A.Autonomy B. Beneficience C. Nonmaleficence D. Justice
Autonomy
What ethical principles are related to the issue of mandated vaccinations? Select all that apply. Autonomy Nonmaleficence Beneficence Integrity
Autonomy Nonmaleficence Beneficence
When removing PPE it is important to know what areas of the PPE are considered "clean"vs. "contaminated" . select all the areas on PPE that are considered clean. A. Ties on the gown B. Outside of the mask C. Sleeves of the gown D. Back of the gown E. Inside of the gloves F. Straps on the googles
Ties on the gown Back of the gown Inside of the gloves Straps on the googles
Although the client refused the procedure, the nurse insisted and inserted a central line into the patient The administrator of the hospital decides to settle the lawsuit because the nurse is most likely to be found guilty of which of the following? A. An unintentional tort B. Assault C. Invasion of Privacy D. Battery
Battery
How would a nurse plan care for a culturally diverse patient? Only focus on the patients needs and not their beliefs or practices Give care based on what you believe is best for the patient Ask for a new patient Be aware of your own bias and focus on the clients needs, beliefs, and practices
Be aware of your own bias and focus on the clients needs, beliefs, and practices
Vaccinations may cause mild discomfort for a child when administered, but the benefits of protection from the disease, for the child and the community, outweigh the discomfort. What ethical principle is demonstrated in this situation? Justice Fidelity Beneficence Nonmaleficence
Beneficence
True or False, Is this a Pro argument for liver transplants in patients with ALD: Those with end-stage liver disease may benefit from a liver transplant to increase their life expectancy
True
After providing care to a patient with chicken pox, you remove your PPE. which statement is true? A. After removing PPE, it is best to perform hand hygiene with hand sanitizer when the hands are visibly solid B. It is best practice to remove all personal protective equipment in the patient's room C. When removing PPE, the respirator should be removed outside the patient's room D. All statements are true
It is best practice to remove all personal protective equipment in the patient's room
The nurse realizes the client doesn't fully understand the risks and benefits of the procedure. Which of the following describe the nurse's role in obtaining informed consent? Select all that apply. A. Explain the risks and benefits associated with the procedure. B. Describe alternatives to the procedure. C. Witness the client's signature on the consent form. D. Advocate for the client by ensuring she is making an informed decision.
C. Witness the client's signature on the consent form. D. Advocate for the client by ensuring she is making an informed decision.
A woman finds out she is pregnant, she expresses this was not an intended pregnancy and states, "I'm so stupid, I feel so ignorant and embarrassed" Which of the following actions is incorrect by a nurse? a. Assessing the patient's current emotions and well-being b. Answering the questions the patient may have c. Judge the patient d. Provide the patient with necessary information she may need to make a decision regarding the pregnancy
Judge the patient
The nurse is preparing to care for a dying client, and several family members are at the client's bedside. Which therapeutic techniques should the nurse use when communicating with the family? Select all that apply. A.Discourage reminiscing. B.Make the decisions for the family. C.Encourage expression of feelings, concerns, and fears. D.Explain everything that is happening to all family members. E.Touch and hold the client's or family member's hand if appropriate. F.Be honest and let the client and family know that they will not be abandoned by the nurse
Encourage expression of feelings, concerns, and fears. Touch and hold the client's or family member's hand if appropriate. .Be honest and let the client and family know that they will not be abandoned by the nurse
A nurse is caring for a terminally ill patient contemplating PAS with family at the bedside. Which therapeutic techniques should the nurse use when conversing with the patient's family? a)Make the decisions for the family b) Encourage the family to express feelings and fears c)Promise the family that everything will be okay d)Discourage reminiscing
Encourage the family to express feelings and fears
Which test used to diagnose the basis of infertility done during the luteal or secretory phase of the menstrual cycle? a. Hysterosalpingogram b. Endometrial biopsy c. Laparoscopy d. Follicle-stimulating hormone (FSH) level
Endometrial biopsy
What are the ethical requirements of liver transplants? (select all that apply) a.Equity b.Utility c.Veracity d.Futility
Equity .Utility
Which of the following can have an impact on the population for pro vaccination? Select all that apply. a) Extending life expectancy b) Reducing the number of complications of infectious diseases C) Improve quality of life d) Preventing death
Extending life expectancy' Reducing the number of complications of infectious diseases Improve quality of life
True or False, Is this a Con argument for liver transplants in patients with ALD: Liver damage is self-induced. Alcoholism that led to end stage liver disease is the result of a patient's voluntary actions and, thus these patients are taking a scarce resource away from patients who are purportedly "more deserving."
False
Although remarkable developments have occurred in reproductive medicine, assisted reproductive therapies are associated with a number of legal and ethical issues. Nurses can provide accurate information about the risks and benefits of treatment alternatives so couples can make informed decisions about their choice of treatment. Which issue would not need to be addressed by an infertile couple before treatment? a. Risks of multiple gestation b. Whether or how to disclose the facts of conception to offspring c. Freezing embryos for later use d. Financial ability to cover the cost of treatment
Financial ability to cover the cost of treatment
Though developments have occurred in reproductive medicine, assisted reproductiv therapies are associated with a number of legal and ethical issues. Nurses can provide accurate information about the risks and benefits of treatment alternatives so couples can make informed decisions about their choice of treatment. Which issue would not need to be addressed by an infertile couple before treatment? a. Risks of multiple gestation b. Whether or how to disclose the facts of conception to offspring c. Freezing embryos for later use d. Financial ability to cover the cost of treatment
Financial ability to cover the cost of treatment
A nurse is working in a neonatal intensive care unit (NICU) where a premature baby (26 weeks gestation) is facing respiratory disorders, numerous infections, and a brain hemorrhage. The parents want every measure to be taken to keep their baby alive, but several members of the health care team are advocating removal of life support. The nurse believes there are several ethical issues involved in this case. What step should the nurse take first when facing an ethical dilemma? a.Gather as much information as possible about the situation b.Identify the options available in this situation c.Act in a fair and equitable manner for all involved d.Evaluate the actions taken using ethical principles
Gather as much information as possible about the situation
A patient requires nasotracheal suction. The patient is receiving medical treatment for Mycoplasma Pneumoniae. Select the PPE you would wear for this procedure. A. Gloves and mask B. Gloves, gown, goggles and mask C. Goggles and mask D. Gloves and goggles
Gloves, gown, goggles and mask
Which of the following states does not allow physician assisted death? A.Oregon B.Colorado C.Nebraska D.Vermont
Nebraska
What are examples of social determinants of Transplants? (select all that apply) a.Neighborhood/environment b.Political Party c.Education d.Economic Stability
Neighborhood/environment .Education Economic Stability
When referencing the Ethical Decision Making Model, which ethical principle focuses on " giving individuals mandatory vaccinations, but allowing individuals to have a choice to receive it, also providing incentives for vaccinated individuals"? A. Beneficence B. Non-maleficence C. Autonomy D. Justice
Non-maleficence
A patient diagnosed with Parkinson's disease asks the nurse to help "end her suffering". Based on the ANA position statement about assisted suicide, how should the nurse respond? a) I understand your feelings of distress, but there is nothing I can do b) Let's discuss your options about when you want to die c) I will do everything in my power to keep you as comfortable as possible, however I am unable to administer a lethal dose or injection d) Are you sure this is the way you want to go?
I will do everything in my power to keep you as comfortable as possible, however I am unable to administer a lethal dose or injection
What assisted reproductive technology injects a single sperm into a mature egg, method often used for couples with male infertile? a) In Vitro Fertilization (IVF) b) Intracytoplasmic Sperm Injection (ICSI) c) Conventional Fertilization d) Gamete intrafallopian transfer (GIFT)
Intracytoplasmic Sperm Injection (ICSI)
What are the two factors that the Organ Procurement and Transplantation Network apply to ensure a balanced decision? a) Beneficence and justice b) Nonmaleficence and beneficence c) Justice and medical utility d) Autonomy and social justice
Justice and medical utility
The nurse is caring for a client who has a medical diagnosis of end-stage chronic obstructive pulmonary disease (COPD). The client is in severe respiratory distress and tells the nurse, "Put me on the machine." The client's family says, "No, we are not going to do this again." The client has a do-not-resuscitate (DNR) order. What is the nurse's priority action? a.Prepare the client for intubation and mechanical ventilation. b.Talk to the family about the client's right to change his mind. c.Administer an anti-anxiety medication to the client to ease his breathing. d.Notify the health care provider that the client is rescinding the DNR order.
Notify the health care provider that the client is rescinding the DNR order.
Which of the following is not a criteria to be a candidate for physician assisted death? A.Resident of an approved state B.18 years and older C.One verbal and one written request from the patient wanting to end their life D.Two physicians agreeing the patient has less than six months to live
One verbal and one written request from the patient wanting to end their life
The obtaining, transferring, and processing of organs for transplantation through systems, organizations, and programs is called: a) Organ donation process b) Organ procurement c) Required response d) The transplantation network
Organ procurement
Which of the following is NOT an argument stated previously for being against mandatory vaccinations? a) Violation of autonomy and choice b) Patient safety and duty of care will be maintained c) Does not provide 100% protection against infectious agents d) Can cause adverse reactions in many people
Patient safety and duty of care will be maintained
If one were to use the "random selection" method of resource allocation, what would be the main ethical issue regarding that? a) "Random selection" ignores the sickest or what saves the most lives b) There is no ethical dilemma regarding "random selection" c) "Random selection" is lazy selection d) "Random selection" would eradicate the ethical issues of resource allocation entirely
Random selection" ignores the sickest or what saves the most lives
What is the best way the nurse can explain resource allocation to a patient who has been asking questions regarding who gets the resources? a) If I like you, I will allocate the resource to you b) I can't talk right now, but you can Google it on your own c) You seem to be the closest to death, so you will likely get the resource first, don't worry d) Resource allocation is based on a multitude of factors in order to fairly treat those who are most in need using a comprehensive view of the patient's health and medical history
Resource allocation is based on a multitude of factors in order to fairly treat those who are most in need using a comprehensive view of the patient's health and medical history
What adverse reaction to vaccinations will exclude someone from receiving vaccinations in the future? Swelling and redness at the injection site Shortness of breath leading to a narrow blocked airway Irritability Temperature of 99.6 F
Shortness of breath leading to a narrow blocked airway
Physician assisted death can be perceived as: A. rule of double effect B. Slippery slope C. Futile treatment D. Near miss
Slippery slope
The nursing code of ethics is written and published by: The Nurse Practice Act The American Nurses Association The National League for Nursing Lienhard School of Nursing
The American Nurses Association
1.The primary care provider wrote a do-not-resuscitate (DNR) order at the request of the patient. In planning nursing care for this patient, the nurse will address what? a.The patient may no longer be able to comprehend or make decisions regarding his or her own health care. b.The patient and family know that the patient will most likely die within the next week. c.The nurses will continue to provide treatments focused on comfort care, symptom management and providing an overall better quality of life. d.In a previous admission, the patient filed a DNR form so therefore it is still valid for the current admission.
The nurses will continue to provide treatments focused on comfort care, symptom management and providing an overall better quality of life.
True or false. Traditional surrogacy is a form of surrogacy in which the surrogate donates her eggs, which are artificially inseminated using sperm fro a prospective father. a. False. Traditional surrogacy is a form of surrogacy in which a woman carries an embryo to which she has no genetic relationship (the embryo is created from the egg and sperm of the prospective parents) b. False. Traditional surrogacy is a form of surrogacy where the prospective father and surrogate mother perform consensual conception of a child. c. True d. False. Traditional surrogacy is a form of surrogacy where the prospective mother and surrogate father perform consensual conception of a child.
True
A patient wants to discuss Physician Assisted Suicide with their nurse. They are confused about the subject and would like some guidance. What is the first thing the nurse should do in this situation? a) Assess the patient's ability to comprehend the situation and make a decision b) Understand and decide their own values and beliefs on the subject c) Advise them to discuss their concerns with their physician d) Offer them pamphlets and other reading material to help educate them with the topic
Understand and decide their own values and beliefs on the subject
Which statement MOST accurately describes the purpose of vaccinations? a) Vaccines prevent the formation of antibodies against a specific antigen b) Vaccines provide IgG antibodies to protect against infection c) Vaccines work by suppressing the amino acid Immunoglobulin sequence d) Vaccines work by stimulating the humoral immune system
Vaccines work by stimulating the humoral immune system
Based on the previously discussed ethical dilemmas regarding resource allocation, which assessments could you perform to evaluate who is "sickest?" A. Vital signs B. Age of patient C. When the patient had breakfast D. What time it is currently E. Patient's medical history
Vital signs
A woman arrives at a prenatal clinic and explains to the nurse her pregnancy was not planned and unwanted. At what point, if the woman does, will she change her mind about the unwanted pregnancy? a. Around the third month b. After seven months c. She never will change her mind d. When quickening occurs
When quickening occurs
When as the nurse would you decide that the patient can not make their own medical decision ? A.When the patient can not speak the language and has no family members to help translate B.When the patient is in severe pain C.When the patient does not want to be bothered with D.When the patient loses consciousness and is considered incompasiatted
When the patient loses consciousness and is considered incompasiatted
Which of the following refer to the single cell that reproduces itself after conception? a. Trophoblast b. Zygote c. Blastocyst d. Chromosome
Zygote
What are unresolved issues regarding the retrieval of a person's organs in accordance with the legal definition of death? (Select all that apply.) a) Properly caring for the dying person until death is pronounced b) The well-being of family members who must say goodbye to their dying loved one c) Family members demanding for organs to not be donated d) Perceived good of the organ donation itself
a) Properly caring for the dying person until death is pronounced b) The well-being of family members who must say goodbye to their dying loved one d) Perceived good of the organ donation itself
The nurse reviews informed consent with a group of nursing students. Which conditions must the informed consent meet to be valid? (select all that applies) a)There is adequate disclosure b)The nurse explains the procedure to the client c)The informed consent is given voluntarily d)The client has sufficient comprehensions. e)The client is under the influence of morphine
a)There is adequate disclosure c)The informed consent is given voluntarily e)The client is under the influence of morphine Rationale: In order for informed consent to be valid there must be adequate disclosure, voluntary informed consent and has sufficient comprehensions. The patient's provider must explain the procedure, a nurse may reinforce information but explaining the procedure comes from the provider. Informed consent must be obtained when the client is not under the influence of any altering medications such as morphine, alcohol, or drugs that may impair comprehension of the procedure.
Which people would a new grad nurse recognize as people who are at risk for altered decision making capacity? (Select all that apply) a)An emancipated 17 year old who does not want to continue chemotherapy treatments for terminal cancer b)An intoxicated 25 year old c)A patient who is admitted following an opiate overdose d)A 19 year old who has divorced parents e)A 16 year old patient who has a history of psychiatric disorders f)A great grandmother who has had dementia for 6.5 years
b)An intoxicated 25 year old c)A patient who is admitted following an opiate overdose e)A 16 year old patient who has a history of psychiatric disorders f)A great grandmother who has had dementia for 6.5 years Rationale: People who are most likely at risk for altered decision making capacity include people who are under the age of 18 and considered a minor, someone who is under the influence of drugs and or alcohol, as well as someone who has an altered mental status due to a disease or change in level of consciousness due to an acute or chronic illness.
In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable? a)Nurses understand the principle of autonomy to guide respect for a patient's self-worth. b)Nurses have a scope of practice that encourages their presence during ethical discussions. c)Nurses develop a relationship with the patient that is unique among all professional health care providers. d)The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care.
c)Nurses develop a relationship with the patient that is unique among all professional health care providers. Rationale: A nurse-patient relationship offers therapeutic communication, which develops mutual trust and respect for one another. The nurse-patient relationship assists with the patient's physical, emotional, and spiritual needs through skill and knowledge. This offers the patient a foundation for understanding and assisting with needs. The patient preferences and beliefs remain of the utmost importance.
The correct sequence for donning PPE is the following: gloves, mask/respirator, goggles/face shield, gown TRUE OR FALSE
false gown, mask, goggles, gloves
