foundations exam 2

A nurse pulls the curtains closed before changing the dressing of the surgical wound on the abdomen of a postsurgical client. What value is served?

Dignity

A 22-year-old woman who recently immigrated to the country has been admitted to the hospital with an ovarian cyst. Both the client and spouse do not speak the dominant language of the new country, and this has complicated the ability of the care team to obtain informed consent for surgery. What action should the care team take to communicate with the client?

Organize professional interpretation, either in person or by telephone.

The nurse is assessing a toddler of Asian- American ethnicity and notes dark blue spots on the infant's lower back . What action should the nurse take?

Press lightly on the pigmented area and observe the toddler's reaction.

Which is an example of nonmaleficence?

Protecting clients from a chemically impaired practitioner

The nurse is caring for a 65-year-old widower whose spouse died 4 months ago. The client tells the nurse about not doing well and that no one will talk with him about his spouse. Which is the nurse's priority intervention for this client?

Refer the client to a support group

An on-duty nurse discovers that a colleague is pilfering medicines. According to the Nurse Practice Acts, what should the nurse do?

Report the incident to the supervisor.

A client with a diagnosis of colorectal cancer has been presented with the treatment options, but wishes to defer any decisions to an uncle, who acts in the role of a family patriarch within the client's culture. The client's right to self-determination is best protected by:

respecting the desire to have the uncle make choices on the client's behalf.

A client who is scheduled for abdominal surgery gives informed consent. While reviewing the client's medical record, the nurse identifies the consent form, interpreting it as most reflective of:

protection of the client's right to self-determination in decision-making.

A group of nurse researchers has proposed a study to examine the efficacy of a new wound care product. Which aspect of the methodology demonstrates that the nurses are attempting to maintain the ethical principle of nonmaleficence?

-The nurses are taking every reasonable measure to ensure that no participants experience impaired wound healing as a result of the study intervention.

A nurse has completed 4 hours of an 8-hour shift on a medical-surgical unit when the nursing supervisor calls. The nursing supervisor directs the nurse to give a report to the other two nurses on the medical-surgical unit and immediately report to the telemetry unit to assist with staff needs on that unit. The nurse informs the supervisor that the nurse has been busy with client assignments and feels this will overwhelm the nurses on the medical-surgical unit. The supervisor informs the nurse that the need is greater on the telemetry unit. This is an example of which type of ethical problem?

Allocation of scarce nursing resources

The alert and oriented client has just been notified of a terminal cancer diagnosis and the need for surgery to extend life. The client tells the nurse, "I am leaving. I am not having the surgery." The client refuses to wait and talk to the primary care provider. What is an appropriate action by the nurse?

Ask the client to sign a form stating that the client is being discharged against medical advice.

A middle-aged adult discusses the loss of a job due to frequent illness. Which will the nurse discuss with the client to assist in problem-solving the loss?

Attending church or praying to a higher power

Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?

Care-based ethics

A nurse provides client care within a philosophy of ethical decision-making and professional expectations. What is the nurse using as a framework for practice?

Code of ethics

An unemployed, middle age client detects a lump in the testicle. What is the expected outcome for this client?

He is likely to delay treatment due to limited access to health care.

A client on a surgical unit asks for the nurse's opinion of the surgeon. The nurse says that the surgeon is rude and that the surgeon's clients always end up with infections. The nurse is at risk of being accused of which?

Slander

A 7-year-old child has been the victim of abuse. The child appears stoic and disconnected while being interviewed by the nurse. Although the child currently has a painful injury, the child does not cry or flinch when the area is touched. Which explains the child's stoic behavior?

The child has learned to cope by shutting off feelings.

A nurse is caring for a client with decreased secretory immunoglobulin A (SIgA). Which health problem might the client face because of this condition?

The client is at a risk for severe infections or cancer.

What best describes the utilitarian theory of ethics?

The consequences of an action determine if it is right or wrong.

A client nearing the end of life requests that the client be given no food or fluids. The physician orders the insertion of a nasogastric tube to feed the client. What is the primary concern of the nurse providing care?

The nurse faces an ethical dilemma about inconsistent courses of action.

A client arrives at a health care facility complaining of pain in the abdomen and diarrhea. The physician diagnoses the client with colitis, an acute illness. Why is colitis considered an acute illness?

The onset is sudden.

The nurse is pulled to a unit where functional nursing is performed. Which nursing actions are appropriate when providing client care this medical-surgical unit?

administering medications to all assigned clients while a colleague provides all treatments, such as wound care to the same group of clients

While at lunch, a nurse heard other nurses at a nearby table talking about a client they did not like. When they asked him what he thought, he politely refused to join in the conversation. What value was the nurse demonstrating?

basic respect for human dignity

Which word is most closely associated with the term "ethics"?

conduct

Two children need a kidney transplant. One is the child of a famous sports figure, whereas the other child comes from a low-income family. What ethical consideration is relevant to the nurse as an advocate for these clients?

cost-effectiveness and allocation

A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist, and learns that the nurse wrongfully attributed the disease to the client's contact with sex workers. With what legal action could the nurse be charged?

slander

The nurse discovers that a recently admitted client does not speak the same language as the nurse. Which action would the nurse take?

Arrange for a trained language interpreter.

While assessing an older adult client's upper back, the nurse notes round, raised red spots along the client's back. The client's daughter says, "Oh, that is just cupping." What action should the nurse take?

Ask about the practice of cupping.

Which of the following illustrates the activity of acting in values clarification?

respecting the human dignity of all clients

A nurse working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed?

battery

A client who is cognitively impaired is scheduled to undergo surgery. The nurse demonstrates understanding of the principle of autonomy and checks the client's health record to ensure that consent has been obtained from which person?

surrogate decision-maker

A competent adult client is scheduled for surgery. Who signs the informed consent form to allow the surgery?

the client

The nurse is assigned to various clients on a medical unit. Which statement(s) made to a client by the nurse constitutes assault? Select all that apply.

-"I am going to insert a catheter in you, if you do not get up to go to the bathroom." -"Hold still for these stitches; otherwise, I am going to have to hold you down."

An adolescent expresses concern that a friend is under "a lot of stress" with home life, classes, clubs, community service, and part-time work. The adolescent asks the nurse what medication the friend should take to "calm down." Which response by the nurse will be supportive of the client?

"Do you think your friend would be willing to sit down and talk with me? I would like to get to know your friend better so I can suggest some healthy alternatives."

The nurse is reviewing the health history of a Native American/First Nations client. Which statement made by the client would require immediate follow-up by the nurse?

"I drink alcohol occasionally, but all my family members do."

The nurse is caring for a client diagnosed with asthma. The client reports drinking herbal tea to treat illnesses. Which additional questions will the nurse ask during the assessment? Select all that apply.

-"Do you take any other supplements?" -"How many cups of herbal tea do you drink in a day?" -"Have you shared this information with your health care provider?"

The beginning nurse is managing a team alone for the first time. Several ethical situations have occurred throughout the day that have caused the nurse to question the nurse's career choice. What actions should the nurse take to build resilience? Select all that apply.

-Cultivate relationships with other people who are supportive. -Ensure that the nurse takes entitled breaks and a lunch during the shift.

A client who is a single parent of two small children is working two part-time jobs. The client comes into the clinic for an appointment looking disheveled and fatigued. Which health promotion activities would this client benefit from? Select all that apply.

-reduction of stressors -perfection reduction

The nurse is caring for a client on a postsurgical unit. At change of shift, the nurse will have completed documentation for this client that includes which component(s)? Select all that apply.

-specific times of day when the client's surgical dressing was assessed and changed

The nurse is preparing to create a plan of care for a client admitted with chronic obstructive pulmonary disease (COPD). Which intervention(s) will directly help the client achieve the goal of self-actualization? Select all that apply.

-teaching the client about the COPD diagnosis -educating the client about the course of the disease process -creating a treatment and prevention plan to decrease readmissions

A nurse is caring for a client with a urinary tract infection. The client is anemic and has a hemoglobin count of 8 g/dl (80 g/L). Taking into consideration that the client is from a Mediterranean country, what should the nurse's most appropriate action be?

Ensure that the drug ciprofloxacin is not prescribed.

A nurse is providing care for three clients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute client still receives a reasonable amount of time, attention, and care during the course of the shift. Which ethical principle is the nurse attempting to practice?

Justice

A nurse is caring for a client with hypertension whose blood pressure has increased from 154/78 mmHg to 196/98 mmHg with a heart rate of 110 beats per minute during the past hour. The nurse goes to lunch without reporting the change to the health care provider, and the client experiences a cardiac arrest. What tort has the nurse likely committed?

Negligence

A nurse using the principle-based approach to client care seeks to avoid causing harm to clients in all situations. What is this principle known as?

Nonmaleficence

Fifteen years ago, a client lost the right leg in a motor vehicle accident. Since then, the client and the client's spouse have formed a walking group to raise money for the homeless. Why would the client be considered healthy?

The client is experiencing a high quality of life within the limits of their physical condition.

A client is admitted with symptoms of psychosis. The nurse hurries to the client's room on hearing the client calling for help. The nurse finds the client lying on the ground. The nurse assists the client back to the bed and performs a thorough assessment. The nurse informs the physician and completes the incident report. Which statement should the nurse document in the incident report?

The client was found lying on the floor.

A nurse is caring for a child with Huntington's chorea, a hereditary condition. Which statement is true of hereditary conditions?

The condition is acquired from genes of one or both parents.

A client arrives at a health care facility reporting diarrhea and abdominal pain for the past 24 hours. The health care provider diagnoses the client with gastritis, an acute illness. Why is gastritis considered an acute illness?

The onset is sudden.

Which definition best describes acute illness?

The rapid onset of symptoms lasting a relatively short time

A client gets out of bed following hip surgery, falls, and re-injures the hip. The nurse caring for the client knows that it is the nurse's duty to make sure an incident report is filed. Which statement accurately describes the correct procedure for filing an incident report?

The report should contain all the variables related to the incident.

A client is dealing with the death of a spouse 10 days ago. The client tells the nurse about not feeling like eating and struggling to get food in. What does the nurse identify is occurring with the client?

This is part of the normal sympathetic stress response.

Which phrase best describes a value?

a belief about the worth of something to guide behavior

A group of nursing students is reviewing the ANA's current code of ethics. A code of ethics is important in the nursing profession because:

nursing practice involves numerous interactions between laws and individual values.

A nurse is concerned about the practice of routinely ordering an extensive series of laboratory tests for clients who are admitted to the hospital from a long-term care facility. An appropriate entity for addressing this ethical dilemma would be:

the institutional ethics committee.

A nurse has been assigned to the ICU by a supervisor because of a number of sick calls. However, the nurse is not highly experienced in providing intensive nursing care. What would be the most appropriate action by the nurse?

to report to the nurse in charge for duty but explain the nurse's practice limitations

A client is received in a postoperative nursing unit after undergoing abdominal surgery. During this time the nurse failed to recognize the significance of abdominal swelling, which significantly increased during the next 6 hours. Later, the client had to undergo emergency surgery. The lack of action on the nurse's part is liable for action. Which legal term describes the case?

tort

A nurse is educating a client about how the general adaptation syndrome (GAS) theory works in the human body. What statement(s) made by the client indicates to the nurse that further education is required? Select all that apply.

-"The alarm reaction alerts my family that I need to slow down." -"I often get exhausted when I do too much yardwork." -"The fight-or-flight reaction is initiated by growth hormone released in my brain." -"The alarm reaction may last for days."

The adult children of a client diagnosed with brain death are trying to come to terms with this diagnosis. Which statement(s) by the children exhibits normal grieving to the nurse? Select all that apply.

-"We have to accept this is really happening right now." -"She would want us to donate her organs to others." -"I am so angry with mom for leaving all of us so suddenly." -"I just need to get out of here right now and go for a walk." -"We should start thinking about the funeral arrangements."

A first-time mother is in her second trimester and the prenatal screening has indicated the possibility of Down syndrome. While awaiting the results of amniocentesis, the client acknowledges anxiety. Which intervention(s) by the nurse will be helpful to the client? Select all that apply.

-Actively listen to the client with full attention -Encourage the client to express emotions -Label the client's emotion, noting fear -Restate the feelings the client has expressed -Engage the client in planning the next steps

The nurse participates in a religion that prohibits abortion. The nurse is to provide care to a client who is seeking an abortion because continuing the pregnancy will threaten the client's life. Place in order the steps the nurse should use to guide ethical decision-making. Use all options.

-Assess the client's overall situation. -Identify the nurse's ethical problem. -List options and weigh consequences. -Implement one's decision. -Evaluate one's decision.

What are common elements in a state's nurse practice act? Select all that apply.

-Definition of legal scope of nursing practice -Creation of a state board of nursing -Criteria for the education of a licensed practical nurse -Requirements for the licensure of the registered nurse

A nurse is planning a seminar for the local community. Which topics are examples of health promotion discussions? (Select all that apply.)

-Examples of heart-healthy diet -Information on increasing activity and exercise

A group of nurses is participating in a community health fair and is engaged in primary prevention activities. Which activities would these nurses be leading? Select all that apply.

-Family planning services -Accident prevention education -Heart-healthy nutrition services

A nurse has applied soft wrist restraints to a client following endotracheal intubation. Documentation of which information is essential when using restraints on a client? Select all that apply.

-Findings from patient assessment, performed every 2 hours -Foley catheter draining clear yellow urine -0.9 normal saline infusing intravenously at 100 mL/hr

A nurse is caring for a client in the community who is at risk for sudden death from a chronic health condition. To reduce the legal risks associated with working with this client, the nurse carries out which action(s)? Select all that apply.

-Follow the prescribed plan of care for the client. -Explain every nursing intervention in detail. -Document nursing actions shortly after completion.

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that the nurse has made. The nurse is most clearly demonstrating which professional value?

-Integrity

Which statement accurately describes a characteristic of ethics? Select all that apply.

-It is important to distinguish ethics from religion, law, custom, and institutional practices. -Values are intimately related to, and direct, ethical conduct.

A nurse has started a new job and is weighing the pros and cons of obtaining professional liability insurance. Why would the nurse choose to obtain professional liability insurance? Select all that apply.

-It provides for an attorney to represent the nurse in malpractice cases. -It covers incidents that occur during employment even after the nurse has left that employment. -It covers advice and care given outside the employment area. -It covers issues such as libel and slander.

The spouse of a client on hospice at home is diagnosed with "caregiver burden." Which intervention(s) will the nurse use to assist the caregiver? Select all that apply.

-Problem solve with the spouse to create a plan for respite -Problem solve with the spouse to create a plan for respite -Offer the spouse ideas for emotional coping mechanisms -Provide the name of a local caregiver support group -Suggest ways the spouse can maximize time and effort

The nurse is on the way to work and witnesses a motor vehicle accident. The nurse has a first aid kit in the car. No emergency medical personnel have arrived. What actions by the nurse would be protected by Good Samaritan laws? Select all that apply.

-Splints an extremity in which a broken bone is present -Applies a gauze dressing to an open wound -Initiates cardiopulmonary resuscitation (CPR) for a person who has stopped breathing -Fails to obtain consent to provide treatment to a victim who is unresponsive

Which scenario(s) exemplifies shared decision-making? Select all that apply.

-The client expresses a desire to be treated at home but agrees to hospitalization for intravenous antibiotics for cellulitis. -The nurse demonstrates to a receptive family member the proper steps to change the leg dressing when the client is at home -The nurse asks the postoperative client which route of opioid medication is preferred for pain relief.

Nurses are working in an emergency department (ED). Which nurses are acting in a moralizing manner? Select all that apply.

-The client frequently visits the ED for various reports of pain. The nurse tells another nurse, "That client is drug seeking." -The client is found to be at fault in a motor vehicle accident in which others are injured. The nurse delays treatment for this client.

Which scenarios are examples of a nurse committing a tort? Select all that apply.

-The nurse told the client, "The doctor prescribed this medication, and you must take it. I'll force you to take it." -The nurse tells another employee, "Everyone knows the previous nurse does not do the job and charts medications not administered." -The nurse administered a sedative medication to a sleeping client because the client's child requested the parent receive it.

Which is a targeted health goal(s) in the Healthy People 2030 initiative? Select all that apply.

-increase the proportion of health and wellness and treatment programs and facilities that provide full access for people with disabilities -reduce the number of new cases of cancer as well as the illness, disability, and death caused by cancer -reduce incidence of tuberculosis

The nurse is caring for a client living in a long-term care facility who has a diagnosis of dementia. While caring for this client, which action(s) taken by the nurse would constitute malpractice? Select all that apply.

-leaving bedrails down when the client is sleeping -informing the client he or she must use the nurse call bell to receive care -holding the client's dinner meal until the client agrees to take medication -sharing the client's health status with all inquiring family members

An occupational health nurse at an oil refinery on the Gulf Coast of Texas performs client education with an adult client. The client is being seen after having suffering a chemical burn in an accident at the refinery. Which type of stressor has this client been exposed to?

-physiologic

A nurse is sitting with friends in a coffee shop while working on a plan of care for a client. The client's name is written at the top of the plan. Which ethical responsibility is the nurse violating?

Confidentiality

A nurse is explaining A1C diagnostic testing to a client with diabetes. What level of health care delivery does this test suggest?

Primary

A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics?

Fidelity

A nurse is providing care to two clients who are sharing the same room. The nurse is preparing to give one of the clients a complete bed bath. Which action by the nurse would suggest liability related to invasion of the client's privacy?

Keeping the curtain between the two clients in the room open

Recent staffing shortages on a hospital unit have resulted in unlicensed care providers being assigned to duties that are beyond their scope of practice. This has resulted in a number of near misses involving client safety. How should a nurse best respond to this trend in care?

Make the appropriate hospital authorities aware of this practice.

A woman always thanks clerks at the grocery store. The woman's daughter, age 6 years, echoes the thank you. The child is demonstrating what mode of value transmission?

Modeling

A nurse does not assist with ambulation a postoperative client on the first day after surgery. The client falls and fractures a hip. What charge might be brought against the nurse?

Negligence

A nurse needs to bathe a client at the health care facility. What is the most appropriate action of the nurse before washing the client's hair?

Seek permission from the client.

A nurse is caring for a very weak client with multiple pregnancies. Which view would a teleologist have in such a situation?

Support the procedure of selective abortion.