Med Surg Quiz 7: Ethics, Law, Culture, Environment

Nursing staff members are sitting in the lounge taking their morning break. An unlicensed assistive personnel tells the group that she thinks that the unit secretary has acquired immunodeficiency syndrome and proceeds to tell the nursing staff that the secretary probably contracted the disease from her husband, who is supposedly a drug addict. Which legal tort has the UAP violated?

slander

The nurse is preparing an educational session that focuses on health promotion activities for the middle aged adult. What is the purpose of this teaching?

Emphasize activities that maintain wellness.

An Asian American client is experiencing a fever. The nurse recognizes the client is likely to self treat the disorder, using which method?

foods considered yin. (yin food is cold, yang food is hot)

A patient with a terminal illness is demonstrating signs of imminent death. What should the nurse keep in mind about the treatment of pain at the end of life?

There is no maximum allowable dose for opioids during end-of-life care.

An 87 year old woman is brought to the ER for treatment of a fractured arm. On physical assessment, the nurse notes old and new ecchymotic areas on the client's chest and legs and asks the client how the bruises were sustained. The client, although reluctant, tells the nurse in confidence that her son frequently hits her if supper is not prepared on time when he arrives home from work. Which is the most appropriate nursing response?

"As a nurse, I am legally bound to report abuse. I will stay with you while you give the report and help you find a safe place for you to stay."

A hospitalized client tells the nurse that a living will is being prepared and that the lawyer will be be bringing the will to the hospital today for witness signatures. The client asks the nurse for assistance in obtaining a witness to the will. Which is the most appropriate response to the client?

"I will call the nursing supervisor to seek assistance regarding your request."

The nurse educator is providing in-service education to the nursing staff regarding transcultural nursing care; a staff member asks the nurse educator to describe the concept of acculturation. The nurse educator should make which most appropriate response?

"It is a process of learning a different culture to adapt to a new or changing environment."

A patient, recently widowed, tells the nurse, "I just can't even get out of bed in the mornings anymore." What response by the nurse would be most helpful in resolving the patient's grief?

"This must be a difficult time for you."

An antihypertensive medication has been prescribed for a client with hypertension. The client tells the clinic nurse that they would like to take an herbal substance to help lower their blood pressure. The nurse should take which action?

Encourage the client to discuss the use of an herbal substance with the health care provider.

Which client(s) has a high risk of obesity and diabetes mellitus? Select all 1. 40 year old Latino American man 2. 45 year old Native American woman 3. 23 year old Asian American woman 4. 35 year old Hispanic American man 5. 40 year old African American woman

1,2,4,5

Which identifies accurate nursing documentation notifications? Select all. 1. The client slept through the night 2. Abdominal wound dressing is dry and intact without drainage. 3. The client seemed angry when awakened for vital sign measurement. 4. The client appears to become anxious when it is time for respiratory treatments. 5. The client's left lower medial leg wound is 3 cm in length without redness, drainage, or edema.

1,2,5

During a home visit the nurse sees that an older patient has a supply of expired antibiotics. What should the nurse do after making this discovery?

Explain how to safely dispose of these medications.

The nurse educator asks a student to list the five categories of complementary and alternative medicine (CAM), which statement indicates understand?

Whole medical systems, mind-body medicine, biologically based practices, manipulative and body-based practices, energy medicine.

The nurse hears a client calling out for help, hurries down the hallway to the client's room, and finds the client lying on the floor. The nurse performs an assessment, assists the client back to bed, notifies the health care provider of the incident, and completes an incident report. Which statement should the nurse document on the incident report?

The client was found lying on the floor

A patient newly diagnoses with a terminal illness states, "I hate this cancer." Accorder to Kubler-Ross, what stage of loss is being verbalized?

Anger

The role of the nurse regarding complementary and alternative medicine should include which action?

Educating the client about therapies that he or she is using or is interested in using.

When communicating with a client who speaks a different language, which best practice should the nurse implement?

Arrange for an interpreter to translate

After seeing a healthcare provider for upper respiratory illness symptoms, a patient is being admitted to the hospital for care. Which illness behavior should the nurse keep in mind when planning care of this patient?

Assuming a dependent role.

The nurse who works on the night shift enters the medication room and finds a co-worker with a tourniquet wrapped around the upper arm. The co-worker is about to insert a needle, attached to a syringe containing clear liquid, into the antecubital area. Which is most appropriate action by the nurse?

Call the nursing supervisor

The nurse is employed in a hospital is waiting to receive a report from the lab via fax. The fax machine activates and the nurse expects the report, but instead receives a sexually oriented photo. Which is most appropriate nursing action?

Call the nursing supervisor and report the incident.

The nurse is concerned that an older patient is at risk for a health problem because of psychosocial stressors. What did the nurse most likely assess in this patient?

Caring for ailing spouse

During an assessment the nurse asks the patient to rate her current health status on a continuum from being well to being ill. Which health factor is the nurse assessing in the patient?

Cognitive development

The nurse calls the health care provider regarding a new medication prescription because the dosage prescribed is higher than the recommended dosage. The nurse is unable to locate the HCP, and the medication is due to be administered. Which action should the nurse take?

Contact the nursing supervisor

The nurse is providing discharge instructions to a Chinese American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The nurse should implement which best action?

Continue with the instructions, verifying client understanding.

A terminally ill patient has died and the nurse is waiting for the family to arrive before moving the patient. What is the primary factor that dictates this family's ritual of mourning?

Culture

The nurse has made an error in a narrative documentation of an assessment finding on a client and obtains the client's record to correct the error. The nurse should take which action to correct the error?

Drawing one line through the error, initialing and dating, and then documenting the correct information.

The nurse if caring for a patient who is dying. Which sense is believed to be the last one lost as an individual nears death?

Hearing

The nurse arrives at work and is told to report (float) to the ICU for the day because the ICU is understaffed and needs additional nurses to care for the clients. The nurse has never worked in the ICU. The nurse should take which action first?

Identify tasks that can be performed safely in the ICU.

The nurse is participating in a conference to identify interventions for an older patient who has started hemodialysis while hospitalized and will be returning home within a week. What is the ultimate goal for this planning session?

Improve the patient and family's ability to manage care needs.

A patient has been referred to hospice and asked what it means. What should the nurse respond to the patient about this type of care?

It is a model of care rather than a place of care.

A patient says, "I don't want anything heroic done if I die. Just let me go." Which document should the patient complete that expresses wishes for life-sustaining treatment in event of terminal illness of permanent unconsciousness?

Living will

A nursing instructor delivers a lecture to nursing students regarding the issue of client's rights and asks a nursing student to identify a situation that represents an example of invasion of client privacy. Which situation, if identified by the student, indicates an understanding of a violation of this client right?

Observing care provided to the client without the client's permission.

The nurse is determining if a patient with Medicare coverage is a candidate for home care. On which purpose should the nurse focus to determine if Medicare will cover this patients home care services?

Patient is newly diagnoses with diabetes and is learning how to self-administer insulin.

The nurse identifies low-risk therapies to a client and should include which therapy(s) in the discussion. Select All 1. Herbs 2. Prayer 3. Touch 4. Massage 5. Relaxation 6. Acupuncture

Prayer, Touch, Massage, Relaxation

A hospital committee is tasked with designing a patient-centered medical home to be implemented for newly discharged patients with chronic diseases. Which concept should the committee chair emphasize when reviewing the purpose of this primary care approach for these patients?

Prevent acute disease crises.

The nurse is planning care of a patient whose spouse recently passed away. Which statement should the nurse keep in mind when planning care for this patient who has experienced loss?

The feeling of loss can only be determined by the person who experiences it.

A client is brought to the ER by EMS after being hit by a car. The name of the client is unknown, and the client has sustained a severe head injury and multiple fracture and is unconscious. An emergency craniotomy is required. Regarding informed consent for the surgical procedure, which is the best action.

Transport the victim to the operating room for surgery.

The nurse has just assisted a client back to bed after a fall. The nurse and health care provider has assessed the client and determined that the client is not injured. After completing the incident report, the nurse should implement which action next?

Reassess the client

The ambulatory care nurse is discussing preoperative procedures with a Japanese American client who is scheduled for surgery for the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior?

Reflecting a cultural value

A patient nearing death requests that no medication be given that would cause a loss of consciousness, including pain medication. What should the nurse do to provide the best end-of-life care for this patient?

Respect the patients wishes and withhold pain medications.

The nurse is planning care to prevent onset of illness for a patient with chronic disease. Which secondary prevention activities would be appropriate for this patient?

Scheduling regular physical exams.

The nurse if caring for a patient who has experienced a loss. For what should the nurse assess that will help the patient successfully resolve grief?

Support systmes

Which meal tray should the nurse deliver to a client of Orthodox Judaism faith who follows a kosher diet?

Sweet and sour chicken with rice and vegetables, mixed fruit, juice. (NO pork, shellfish)

The nurse is making a home visit to a patient recovering from bacterial pneumonia. Which intervention is most important to control infection in the home environment?

Teaching the patient to conduct hand hygiene after expectorating into tissues.

The nurse is preparing a plan of care of care for a client who is a Jehovah's Witness. The client has been told that surgery is necessary. The nurse considers the client's religious preference in developing the plan of care and should document which information?

The administration of blood and blood products is not allowed.