NUR 212 test 3

c (Veracity is the principle behind giving complete information before obtaining a​ client's informed consent. Autonomy is the right of​ self-determination. Justice assures fair treatment opportunities. Beneficence means taking action to promote​ good, but since you have no experience with the new​ drug, you​ don't know whether it will be good for your client or not.)

As a treatment nurse in the oncology outpatient​ clinic, you are doing the admission paperwork with​ 28-year-old client Dorothy​ D'Angelo. Dorothy has a rare form of pancreatic cancer. She qualifies to become part of a clinical trial with a brand new investigational drug that your clinic​ hasn't used yet. As you give Dorothy complete risk information before she signs up to become a research​ participant, which principle of ethical decision making are you​ honoring? a Autonomy b Justice c Veracity d Beneficence

2 Children with autistic-like features lack many social skills, such as seeking reciprocity and comfort from parents and maintaining eye contact when someone is speaking with them.They have an inability to develop peer relationships.

Parents confide to the nurse that their child, who is 35 months old, does not talk and spends hours sitting on the floor watching the ceiling fan go around. They are concerned their child may have autism. The nurse should ask the parents which question? 1. "Does your child have brothers or sisters?" 2. "Does your child seek you out for comfort and love?" 3. "Do you have trouble getting babysitters for your child?" 4. "Does your child receive speech therapy?"

1 Autonomy is the right to make one's own decisions; in this case, the right of the parent to make decisions about the child's surgery. As legal guardian, the parent has the right to choose or not choose for the child to undergo an elective procedure

Shortly before a child's elective surgery, the parent tells the nurse, "I am having second thoughts about my child undergoing this surgery." The nurse respects the par- ent's concern and calls the surgeon. What ethical/moral principle is represented by this situation? 1. Autonomy. 2. Equality. 3. Fidelity. 4. Justice.

b (Rationale The nurse who treats the illegal immigrant in the same manner as a citizen is demonstrating social justice. The nurse who treats the very dirty homeless person with respect honors human dignity. The nurse who honors the decision to reject blood transfusions is supporting​ clients' autonomy. The nurse who offers to work a religious holiday so that others can worship is showing altruism.)

Social justice is an important value for the nursing profession. Which nurse is exhibiting this​ value? a The nurse who offers to work a religious holiday so that others can worship that day b The nurse who treats the illegal immigrant in the same manner as a citizen c The nurse who treats the very dirty homeless person with respect d The nurse who honors the decision of a client to reject blood transfusions

a (Co-worker impairment, whether by drugs or​ alcohol, may interfere with job performance and may result in unsafe clinical​ practice, and must be reported immediately to a supervisor. Nurses are advocates for all​ clients, not just those in their care. Asking the nurse if she is intoxicated could cause confrontation or provide a chance to destroy evidence. The hospital administrator would be notified by the nursing supervisor.)

Tameka Whitt is a nurse who is making rounds on the surgical floor when she notices that one of the staff nurses is in the kitchen drinking from a metal flask. The staff​ nurse's eyes are​ glassy, her speech is​ slurred, and her breath smells like alcohol. Which action by Tameka reflects correct understanding of the​ ANA's Code of​ Ethics? a Contact the supervisor b Contact the hospital administrator c Ask the staff nurse if she is intoxicated d Tell the staff nurse that she should keep an eye on her

1 The ethics committee is composed of health-care workers and laypeople from the community to objectively review the situation and make a recommendation which is fair to both the client and health- care system. The family has the right to be present and discuss their feelings.

The HCP has notified the family of a client in a persistent vegetative state on a ventilator of the need to "pull the plug." The client does not have an AD or a durable power of attorney for health care, and the family does not want their loved one removed from the ventilator. Which action should the nurse implement? 1. Refer the case to the hospital ethics committee. 2. Tell the family they must do what the HCP orders. 3. Follow the HCP's order and "pull the plug." 4. Determine why the client did not complete an AD

b In clients with​ CP, constant stress on the body can cause premature aging. Conditions such as​ hypertension, osteoarthritis, and atherosclerosis often develop before age 40. Numerous clients with CP do live past age​ 30, and this is increasing as symptom management becomes more effective. Independence usually does not increase as a result of​ aging, but the manifestations may become more severe or result in further complications.

The caregiver of a​ 30-year-old client with cerebral palsy​ (CP) asks if there are any changes in health that might develop. Which response should the nurse​ make? A. ​"People with CP​ don't often live past​ 30." B. ​"He will likely develop signs of premature aging as a result of constant stress on the​ body." C. ​"He will gradually become more and more independent as the spasticity in the muscles​ diminishes." D. ​"It is impossible to predict which health changes he will​ experience."

4 The child should be positioned upright to prevent aspiration during meals; there- fore, this action would require the charge nurse to intervene.

The charge nurse has assigned a staff nurse to care for an 8-year-old client diagnosed with cerebral palsy. Which nursing action by the staff nurse would warrant immediate intervention by the charge nurse? 1. The staff nurse performs gentle range-of-motion (ROM) exercises to extremities. 2. The staff nurse puts the client's bed in the lowest position possible. 3. The staff nurse takes the client in a wheelchair to the activity room. 4. The staff nurse places the child in semi-Fowler's position to eat lunch.

1 This requirement is violating the client's autonomy, which is a client's right to self-determination without outside control. This approach has been used as a condition of probation, to allow women accused of child abuse/neglect to get out of a jail term.

The client being seen in the obstetric (OB) clinic tells the nurse, "I don't think it is right that the judge is making me get a contraceptive implant just because they don't think I am a good mother." Which ethical principle does the requirement violate? 1. Autonomy. 2. Justice. 3. Fidelity. 4. Beneficence.

1 Beneficence is the ethical principle to do good actively for the client. Because the client is in the ICU, the client is critically ill and does not need any type of news that will further upset the client. This statement supports the ethical principle of beneficence.

The client is admitted to the critical care unit after a motor vehicle accident. The client asks the nurse, "Do you know if the person in the other car is all right?" The nurse knows the person died. Which statement does not support the ethical principle of beneficence? 1. "I am not sure how the other person is doing." 2. "I will try to find out how the other person is doing." 3. "You should rest now and try not worry about it." 4. "I am sorry to have to tell you, but the person died."

2 Nonmaleficence is the duty to do no harm. Many ethicists think that the principle of nonmaleficence has priority over other ethical principles except for autonomy. Nonmaleficence allows the nurse to answer a question or make a decision that does not create further complications for the client

The client on the postpartum unit tells the nurse, "My husband thinks he is the father of my baby but he is not. What should I tell him?" Which response supports the ethical principal of nonmalfeasance? 1. "You should tell him the truth before he becomes attached to the infant." 2. "How do you think your husband will feel if he knows he is not the father?" 3. "I know my husband would want to know if my child was his or not." 4. "Do you know what the real father is planning on doing about the baby?"

a (The​ client's right to make his own choices about health care is reflective of the ethical principle of autonomy. When the​ client's autonomy is at​ risk, the nurse is ethically obligated to advocate for the client. Confidentiality and privacy pertain to protecting the​ client's personal information from unnecessary or unauthorized access by others.)

The client tells the​ nurse, "I want to make my own choices about which healthcare treatments I receive." Which ethical principle is the client​ describing? a Autonomy b Advocacy c Privacy d Confidentiality

a (Rationale The nurse should not offer an​ opinion, even when the client asks for it. It is not ethical to rely on previous clinical​ experience, assume a neutral​ stance, or use a standard of the fastest recovery time.)

The client who was recently diagnosed with cancer is making a difficult clinical​ decision, choosing between surgery or chemotherapy and radiation. The client asks the nurse "What would you do if you were in my ​shoes? " What is the most appropriate response by the​ nurse? a "I am not an expert in treatment outcome​ research, so I would not want to influence your decision. " b "It really does not matter which way you choose to get​ treatment; either way works as well. " c "I have watched a lot of clients make that​ decision; the ones that chose surgery seemed the happiest. " d "Chemotherapy and radiation take a lot longer to recover​ from; I would advise against them

1 The ethical principle of justice is to treat all clients fairly, without regard to age, socioeconomic status, orany other variable, including clients with special needs. This statement supports the adolescent's right to her opinion even though she has Down syndrome.

The clinic nurse is discussing a tubal ligation with a 17-year-old adolescent with Down syndrome. The adolescent does not want the surgery, but her parents (who are also in the room) are telling her she must have it. Which statement by the nurse would be an example of the ethical principle of justice? 1. "I think this requires further discussion before scheduling this procedure." 2. "You will not be able to have children after you have this procedure." 3. "You should have this procedure because you could not care for a child." 4. "You can refuse this procedure and your parents can't make you have it."

2 This is an example of fidelity. Fidelity is the duty to be faithful to commitments and involves keeping information confidential and maintaining privacy and trust.

The female nurse is discussing an upcoming surgical procedure with a 76-year-old male client diagnosed with cancer. Which action is an example of the ethical principle of fidelity? 1. The nurse makes sure the client understands the procedure before signing the permit. 2. The nurse refuses to disclose the client's personal information to the CNO. 3. The nurse tells the client his diagnosis when the family did not want him to know. 4. The nurse tells the client that she does not know the client's diagnosis.

a Withholding necessary treatment of a child if the case is not futile is child abuse under the Child Abuse and Treatment Act of 1984. The nurse would teach the concerned grandmother and connect her with the needed resources to ensure the proper care of the child. The nurse would not focus on the consent of the parents or potential care of the child or encourage the grandmother to kidnap the child.

The grandmother of a child in need of medical treatment tells a nurse that the parents are withholding consent for necessary care and asks whether this is legal. Which is the​ nurse's best​ response? A. ​"Withholding treatment could be viewed as child​ abuse." B. ​"I cannot discuss issues about potential​ clients." C. ​"The parents ultimately make the​ decision." D. ​"If you kidnap the child to get​ treatment, we'll treat the​ child."

c An appropriate intervention for the family of a child diagnosed with ASD is for the nurse to provide education about what to expect. The nurse would encourage the family to grieve the loss of the​ "perfect child" and encourage the parents to focus on the​ child's strengths and talents. In order for therapy to be​ effective, the nurse would recommend that treatments be continued at home.

The home care nurse is visiting a child diagnosed with autism spectrum disorder​ (ASD). Which intervention is appropriate for the nurse to include in the treatment plan for this​ family? A. Encouraging the family to get over negative feelings regarding the diagnosis B. Focusing on the​ child's limitations C. Providing appropriate education regarding what to expect for the child D. Recommending that the home be a​ therapy-free zone

b (Rationale The nurse could help the client clarify values by helping the client list alternative courses of action. The nurse should stress that the client is making the​ decision, not the​ client's children. The client faces making decisions​ now, in spite of medical​ conditions, so talking about difficult matters should not be postponed.)

The home health nurse is helping a client with congestive heart failure to plan for the future. The client is having difficulty making some final decisions. What question could the nurse ask to help clarify the client​'s ​values? ​a "Are you feeling healthy enough to be making​ decisions?" b "What alternative courses of action have you been thinking ​about?close double quote" ​c "What do you think your children would like you to​ do?" ​d "Do you want to postpone talking about this difficult​ matter?"

c (For clients and healthcare​ providers, testing for HIV and AIDS raises ethical concerns including releasing test results to insurance​ companies; mandating testing of healthcare providers and clients​ (as opposed to allowing voluntary​ testing); and mandatory notification to sexual partners or caregivers of clients who are HIV positive​ (as opposed to voluntary​ disclosure).)

The infection control nurse is giving an​ in-service about issues that raise ethical concerns related to testing for HIV and AIDS. Which item should be​ included? a Allowing clients who are HIV positive to tell caregivers about their HIV status b Testing healthcare providers for HIV on a voluntary basis c Releasing results of HIV tests to insurance companies d Supporting clients who want to notify sexual partners that they are HIV positive

a The team would first develop a therapeutic relationship with the child and parents to discuss options and plan treatment. There is no indication that the police are needed. The ethics committee may be involved if the desires of the parents and child significantly diverge. Legal action would be taken if the parents were making poor decisions regarding the care of the child.

The interdisciplinary team discusses a conflict in​ care-planning ideals between parents and an ill child. Which action should the interdisciplinary team first try to navigate this ethical​ issue? A. Developing a therapeutic relationship with the child and parents B. Asking a judge for guardianship of the child C. Contacting the hospital ethics committee D. Calling the police

2 Veracity is the ethical principle "to tell the truth." The truth is that schizophrenia is a thought disorder caused by a chemical imbalance of the brain. Antipsychotic medication can control the client's hallucinations and delusions.

The mother of a client recently diagnosed with schizophrenia asks the nurse, "I was afraid of my son. Will he be all right?" Which response by the psychiatric nurse supports the ethical principal of veracity? 1. "I can see your fear; you are concerned your son will not be all right." 2. "If your son takes medication, the symptoms can be controlled." 3. "Why were you afraid of your son? Did you think he would hurt you?" 4. "Schizophrenia is a mental illness and your son will not be all right."

c Head​ lag, tonic neck​ reflex, and following objects 180 degrees are all normal for a​ 4-month-old infant. If head lag and tonic neck reflex persist beyond 6​ months, then they would be a concern and suggest CP. Hypotonia is not normal and could be a sign of CP.

The mother of a​ 4-month-old client is concerned that the client may be developmentally delayed. Which finding should lead the nurse to suspect cerebral palsy​ (CP) in the​ infant? A. Tonic neck reflex B. Follows objects 180 degrees C. Hypotonia D. Head lag

a, c, d Prematurity is an etiology of CP that occurs before birth. Fetal viral infection is an etiology of CP that occurs before birth. Genetic factors are an etiology of CP that occurs before birth. Hyperbilirubinemia is an etiology of CP that occurs after birth. Brain injury is an etiology of CP that occurs after birth.

The mother of a​ 4-year-old child with cerebral palsy​ (CP) asks how this health problem occurred. Which prenatal insult should the nurse explain as a possible​ cause? (Select all that​ apply.) A. Prematurity B. Brain injury C. Fetal viral infection D. Genetic factors E. Hyperbilirubinemia

3 Under the shared governance system, the staff is given the opportunity to self-schedule. This provides the nurses with flexibility and autonomy.

The new nurse has accepted a position on a unit that is run using the shared governance model. Which statement is an important precept of this system? 1. The nurse must cover a shift if the manager asks. 2. The nurses are responsible for the care they provide. 3. The nurses schedule themselves to cover the unit. 4. Nurses are never asked to go to another unit to work.

d An assessment finding that supports the diagnosis of ASD is having a tantrum when touched by the healthcare provider. It is not uncommon for the child with ASD to display an inability to attend and systematize situational reactions. Playing with other​ children, speaking to the nurse in​ sentences, and crying after the administration of immunizations are not findings that support ASD. These assessment findings are age appropriate for the client.

The nurse is assessing a toddler client for an upper respiratory infection. The nurse suspects the child may have autism spectrum disorder​ (ASD). Which behavior caused the​ nurse's suspicion? A. Speaking to the nurse in sentences B. Crying after the administration of immunizations C. Playing with the other children and toys while awaiting the nurse D. Having a tantrum when touched by the nurse

a, b, d, e Impairments are noted in the social interactions and ability to adapt socially at the appropriate age level. The young child with ASD will have a decreased ability to communicate as well as an inability to organize situational responses.​ Developmentally, the​ 3-year-old is not old enough for complex thought.

The nurse is assessing a​ 3-year-old child with autism spectrum disorder​ (ASD). In which area should the nurse expect to find​ impairments? (Select all that​ apply.) A. Social interactions B. Ability to organize responses to situations C. Ability to engage in complex thought process D. Communication E. Social adaptability

b, c, d, e Socialization and​ communication, especially understanding nonverbal​ communication, are lifelong struggles for the adult with ASD. Behaviors that the nurse will anticipate during the assessment include choosing inappropriate topics to​ discuss, not engaging in small​ talk, understanding body​ language, and having trouble with double meanings. The nurse would not expect the adult client with ASD to display problems with sentence structure.

The nurse is assessing a​ high-functioning adult client who is diagnosed with autism spectrum disorder​ (ASD). Which characteristic of ASD should the nurse anticipate this client will demonstrate during the nursing​ assessment? (Select all that​ apply.) A. Displaying problems with sentence structure B. Understanding body language C. Having trouble with double meanings D. Choosing inappropriate topics to discuss E. Lacking the ability to participate in small talk

2 The Nissen fundoplication involves wrapping the fundus of the stomach around the inferior esophagus, creating a lower esophageal sphincter or cardiac sphincter.

The nurse is caring for a 6-week-old infant with cerebral palsy and GER. After two hospital admissions for aspiration, the child is scheduled for a Nissen fundoplication. The nurse knows that this procedure involves which of the following? 1. The fundus of the stomach is wrapped around the inferior stomach, mimicking a lower esophageal sphincter. 2. The fundus of the stomach is wrapped around the inferior esophagus, mimicking a cardiac sphincter. 3. The fundus of the stomach is wrapped around the middle portion of the stomach, decreasing the capacity of the stomach. 4. The fundus of the stomach is dilated, decreasing the likelihood of reflux.

a ROM exercises promote flexibility and prevent contracture formation. Muscle​ relaxants, mood​ stabilizers, and speech therapy do not promote flexibility or prevent contractures.

The nurse is caring for a client who has cerebral palsy​ (CP). Which intervention should the nurse use to promote flexibility and prevent​ contractures? A. Perform​ range-of-motion (ROM) exercises B. Schedule speech therapy C. Provide muscle relaxants D. Administer mood stabilizers

b Applying the principle of veracity requires the nurse to be​ truthful, but it is not in the scope of practice for a nurse to disclose information about test results or diagnoses. Acknowledging that results are available and that the healthcare provider will discuss them with the client is truthful. Disclosing the diagnosis is not permitted under the scope of practice of nursing. Saying that the nurse is not allowed to report results may be a true​ statement, but it is not supportive or client centered. Stating that the results are unknown is not a true statement.

The nurse is caring for a client who is awaiting the results of a magnetic resonance imaging​ (MRI) scan to determine the extent of a malignant brain tumor. The results are posted in the medical record and indicate that the prognosis is not​ good, but the healthcare provider has not seen the report yet. The client asks the nurse about the results. Which is the​ nurse's best response under the principle of​ veracity? A. ​"I don't know whether the results have been posted. The healthcare provider will need to give you that​ information." B. ​"The results have been posted on your​ chart, and your healthcare provider will come speak to you after reviewing​ them." C. ​"Your brain tumor has gotten worse and spread to other areas. Your condition is definitely​ worsening." D. ​"I am not allowed to tell you test​ results."

a, c, e A client who has frequent falls​ and/or seizures may require a helmet to protect against head injury. Adaptive seating in an automobile may be required to ensure​ proper, safe restraint. Use of seat belts in wheelchairs or strollers will prevent spastic movements from resulting in falls. Use of splints and braces and​ range-of-motion exercises will promote mobility and muscle​ strength; they are not used to promote safety.

The nurse is preparing discharge instructions for the parents of a child with cerebral palsy​ (CP). Which instruction should the nurse include to promote safety for this​ child? (Select all that​ apply.) A. Helmet to protect against head injuries B. Splints and braces C. Adaptive seating for automobile transportation D. ​Range-of-motion exercises E. Seat belts in strollers and wheelchairs

a, c, d, e Clinical therapy is used for clients who have CP to help them develop their maximum level of independence. To improve motor function and​ ability, referrals are made for​ physical, occupational, and speech​ therapy, as well as special education. Oxygen therapy is not necessary for all individuals with​ CP, only those with breathing disorders who require it.

The nurse is preparing teaching material about cerebral palsy​ (CP). Which nonpharmacologic therapy should the nurse include in this​ teaching? (Select all that​ apply.) A. Occupational therapy B. Oxygen therapy C. Physical therapy D. Speech therapy E. Special education

a, b, d, e Muscle relaxants may help the child with spasticity often associated with CP. Surgery may be helpful for children who experience contractures as a result of CP. Serial casting may be helpful for children with CP. Positioning devices are used to prevent contractures. A​ low-calorie diet is not recommended for children with CP.

The nurse is preparing teaching material for the parents of a child with cerebral palsy​ (CP). Which treatment should the nurse include in this​ teaching? (Select all that​ apply.) A. Positioning devices B. Serial casting C. A​ low-calorie diet D. Muscle relaxants E. Surgery

a The administration of a lethal medication to a client is euthanasia. A DNR order is an example of an advance​ directive, a document that lets caregivers know the desires of the client regarding​ care, especially​ end-of-life care. In assisted​ suicide, the client is provided a lethal dose of medication for​ self-administration.

The nurse is reading a news article in which the ethical dilemma posed by​ end-of-life suffering is discussed. The article describes how a healthcare provider delivered a requested lethal dose of pain medication to a client with a terminal illness. Which​ end-of-life issue does this article​ address? A. Euthanasia B. Assisted suicide C. ​Do-not-resuscitate (DNR) order D. Advance directives

d The ingestion of​ alcohol, tobacco, and toxic substances has been known to cause birth defects.​ Therefore, fetal alcohol syndrome could possibly be a factor in the development of ASD. Childhood vaccinations have not been proven to cause ASD. Appropriate adaptation to new environments and postterm birth have no link to ASD.

The nurse is reviewing the medical record of a​ 6-year-old client diagnosed with autism spectrum disorder​ (ASD). Which item in the health history should the nurse consider may have been a factor in the client developing​ ASD? A. Appropriate adaptation to new environments B. Postterm birth C. Childhood vaccinations D. Fetal alcohol syndrome

a, b, d A​ gluten-free and​ casein-free diet eliminates wheat and dairy products. Foods that support a​ gluten-free and​ casein-free diet include​ cornmeal, grilled​ salmon, and soy milk. Cheese and yogurt are​ casein-rich foods.​ Therefore, they should be avoided.

The nurse is teaching the family of a client diagnosed with autism spectrum disorder​ (ASD) about a​ gluten-free and​ casein-free diet. Which food should the nurse​ include? (Select all that​ apply.) A. Grilled salmon B. Soy milk C. Cheese D. Cornmeal E. Yogurt

a, b, c, d The etiology of ASD is​ uncertain, but it is believed to be the result of an intricate​ co-action between​ genetic, immunologic, and environmental circumstances. There is research being conducted on the role of​ neurotransmitters, such as dopamine and serotonin. There is no evidence that​ mercury-containing vaccinations cause autism.

The nurse is teaching the parents of a child recently diagnosed with autism spectrum disorder​ (ASD). Which etiologies should the nurse​ include? (Select all that​ apply.) A. Genetics B. Environmental factors C. Immunologic factors D. Neurotransmitters E. ​Mercury-containing vaccinations

b, d, e Foods that should be avoided include grains and dairy​ products, such as milk and cheese. Corn and beef can be consumed when following a​ gluten-free and​ casein-free diet. Clients considering a​ gluten-free and​ casein-free diet should be referred for​ counseling, so as to be able to meet the​ child's nutritional needs.

The nurse is teaching the parents of a child with autism spectrum disorder​ (ASD) who is being treated with a​ gluten-free and​ casein-free diet. Which food should the nurse teach the parents to eliminate in the​ child's diet?​ (Select all that​ apply.) A. Beef B. Grain C. Corn D. Cheese E. Milk

a Values clarification is a​ seven-step process that begins with listing the alternatives. The next steps are examining possible consequences of​ choices, freely choosing a course of​ action, feeling good about the​ choice, affirming the​ choice, acting on the​ choice, and acting with a pattern.

The nurse is working with a client with a​ progressive, debilitating muscle disease. The client is struggling with treatment and​ end-of-life decision​ making, so the nurse begins the process of clarifying values. Which is the first step in this​ process? A. Listing alternatives B. Examining possible consequences C. Choosing a course of action D. Acting with a pattern

a,c,d,e (Rationale Factors that contribute to the development of ethical issues in nursing include rapidly changing​ technology, conflicting societal and cultural​ values, conflicting loyalties and obligations among​ nurses, and increasing pressure to contain healthcare costs Approving adequate staffing of nurses would help prevent the development of ethical issues.)

The nurse researcher is designing a poster that describes factors that contribute to the development of ethical issues in nursing. Which items are appropriate for the researcher to include on the​ poster? ​(Select all that​ apply.) a Opposing cultural values b Approving adequate nurse staffing c Adapting to changing technology d Conflicting loyalties among nurses e Emphasizing healthcare cost containment

c (Rationale To help the parents examine possible consequences of their​ choice, the nurse could ask about expected benefits. It is not helpful to challenge the parents about the research basis for their decision. Knowing other parents who have made the same decision does not honor the autonomy of these parents. Clarifying how the parents feel about their decision is different from helping them examine possible consequences.)

The public health nurse is discussing immunization choices with the parents of an infant. The parents have decided to decline routine vaccinations. What question could the nurse ask the parents to help them examine possible consequences of their ​choice? a ​"How do you feel about your decision to withhold​ vaccinations?" ​b "Do you know any other parents who are withholding​ vaccinations?" ​c "What benefits do you foresee from withholding​ vaccinations?" ​d "How much research have you done about withholding​ vaccinations?"

3 Older adults who are hospitalized fre- quently have multiple health problems, are frail, and lack stamina. All of these factors contribute to the inability to maintain balance and ambulate safely

The risk management coordinator is preparing a program on the factors that contribute to falls in a hospital setting. Which factor that most often contributes to falls should be included in the program? 1. Wet floors 2. Frequent seizures 3. Advanced age of patients 4. Misuse of equipment by nurses

c (In application of the primary risk management​ model, resource accumulation involves acquiring the needed resources and coping skills prior to experiencing the stressor. Peer support and consultation are combined to create resources for primary prevention of ethical challenges.​ Education, which should always be combined with didactic​ training, is used to create an additional resource for developing primary risk management skills.)

The risk management coordinator is teaching a seminar about using the primary risk management model to manage ethical dilemmas in nursing. Which component includes developing coping skills prior to experiencing a​ stressor? a Consultation b Education c Resource accumulation d Peer support

c,d,e (Factors that contribute to the development of ethical issues in nursing include rapidly changing​ technology, conflicting societal and cultural​ values, conflicting loyalties and obligations among​ nurses, increasing pressure to contain healthcare​ costs, and reduced staffing of nurses.)

The staff nurse is giving a presentation about factors that contribute to the development of ethical issues in nursing. Which items should be​ included? ​ (Select all that​ apply.) a Increased staffing of nurses b Decreasing emphasis on containing healthcare costs c Conflicts between societal and cultural values d Conflicting loyalties and obligations among nurses e Rapidly changing technology

1 Anencephaly is a congenital abnormality that entails an absence of all or a major part of the brain. The infant has no chance of life outside of a healthcare institution. The healthcare team refers situations to the ethics committee to help resolve dilemmas when caring for clients.

Which client should the newborn nurse refer to the hospital ethics committee? 1. The newborn who is anencephalic whose parents want everything done. 2. The newborn whose 16-year-old mother wants to place the infant up for adoption. 3. The newborn whose mother is a known cocaine user and is HIV positive. 4. The newborn who needs a unit of blood and the parents are refusing consent.

1 Anencephaly is a congenital abnormality that entails an absence of all or a major part of the brain. The infant has no chance of life outside of a health-care institution. The health-care team refers situations to the ethics committee to help resolve dilemmas when caring for clients.

Which client should the newborn nurse refer to the hospital ethics committee? 1. The newborn who is anencephalic whose parents want everything done. 2. The newborn whose 16-year-old mother wants to place the infant up for adoption. 3. The newborn whose mother is a known cocaine user and is HIV positive. 4. The newborn who needs a unit of blood and the parents are refusing consent.

b (One of the ways that professional values are developed is by socialization to nursing by nursing school faculty. Other ways include learning from other nurses and from clinical and life experiences. Professional values are influenced by insight into​ one's own​ values, not​ clients' values, and professional values are not influenced by cultural norms. Professional values demonstrate insight into how values influence​ actions, not how actions influence values.)

Which description is a characteristic of professional​ values? a Insight into how actions influence values b Development of socialization to nursing by nursing school faculty c Influence by cultural norms d Influence by insight into clients​' values

a, c, d Clients with ASD have impaired communication skills. Strategies to improve communication include using​ short, direct sentences that are easy to​ understand, supplementing verbal communication with the use of​ pictures, computers, or other visual​ aids, and using sign language. Deafness is not a clinical manifestation of​ ASD, so speaking loudly will not improve communication and will distress the client.​ Simple, not​ complex, words and sentences are best for communication with the client with ASD.

Which instruction should the nurse include when teaching parents strategies to enhance communication with a child diagnosed with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Using​ pictures, computers, or other visual aids B. Using complex words to stimulate the​ child's vocabulary C. Using​ short, direct sentences D. Considering using sign language E. Speaking loudly

a, d All infants who show symptoms of developmental delay should be evaluated by using two simple screening assessments. The first is a diaper​ pull, which is conducted by placing a clean diaper on the​ child's face; the infant with CP will use one hand or will not remove the cloth at all. The other test is the head​ turn, which is conducted by turning the​ infant's head to one​ side; if the child has a persistent asymmetric tonic neck reflex beyond 6 months of​ age, this indicates a pathologic condition. The Babinski reflex does not indicate the presence or absence of CP. The Phalen test is used to assess for carpal tunnel syndrome. The heel-shin test is used with adults to determine nervous system integrity of the lower extremities.

Which screening assessment should the nurse use for a child demonstrating developmental delays associated with cerebral palsy​ (CP)? (Select all that​ apply.) A. Diaper pull B. Phalen test C. Heelshin test D. Head turn E. Babinski reflex

c

a nurse observes an UAP handling a client roughly, grabbing the clients arm to pull the client out of her room for a scheduled bath. the client had stated that she did not want a bath. which of the following is the most appropriate intervention by the nurse? a. encourage the client to go for her scheduled bath b. ignore the situation as the aide clearly has the situation under control c. report the aide's rough handling of the client to your immediate supervisor d. call the clients physician e. attempt to talk to the aide privately and tell her that you will report her should you observe her mistreating a client again

c

what is the most important intervention when admitting a child with autism spectrum disorder to an acute care unit? a. placement near the nurses station in a semi private room b. placement with another child with autism in a semiprivate room c. placement in a private room down the corridor from the nurses station d. placement in a private room adjacent to the playroom

b

which definition best describes moral distress in the nursing environment? a. when a nurse knows the right thing to do and goes against institutional boundaries to follow through b. when a nurse knows the right thing to do but is constrained by certain institutional obligations that prevent the nurse from following through c. when a nurse does not know the right thing to do in a certain situation and refuses to follow orders d. when a nurse does not know the right thing to do in a certain situation and does nothing

d

while administering medications to a group of clients on a medical surgical unit. a client who is post op from an accidental above the knee amputation indicates to the nurse that he is ready to talk with the client as soon as he finishes administering medications. which of the following ethical principles is the nurse demonstrating? a. veracity b. justice c. nonmaleficence d. fidelity

b

you are working in a pediatric clinic doing screenings and assessments for children from 2-4 years old. as you are doing the neurological and musculoskeletal assessments for a 3 year old male child, you notice that the boy has a strong, reactive tonic neck reflex. what would you suspect? a. normal neck and cervical musculature b. neurological alteration c. strong neck and cervical musculature d. a normal neurologic response

c

your client, a new mother, has stated that she does not want her baby to get immunizations because they cause autism. how should you respond to her fears and concerns? a. 'the chances of your baby getting autism from immunizations are quite low' b. 'the benefits of immunizations greatly outweigh the risk of getting autism' c. 'there is no accepted scientific research that supports the idea that autism is a consequence of vaccinations' d. 'most vaccines now have thimerosal, so the risk of autism is limited to the polio vaccine'

A. Gender bias and ageism Stereotyping an "old man" as "nasty"is a gender bias and an ageism issue. The nurse is verbalizing a negative descriptor about the client.

When the nurse described the client as "that nasty old man in 354," the nurse is exhibiting which ethical dilemma? A. Gender bias and ageism B. HIPAA violation C. Beneficence D. Code of ethics violation

b

a nurse is developing a plan of care for a 4 year old child who has cerebral palsy. which of the following actions should the nurse include? a. structure interventions according to the childs chronological age b. evaluate the childs need for referral to a speech language therapist c. monitor the childs pain level routinely using a numerical pain scale d. provide total care for daily hygiene activities

c (Rationale Resuscitation is an example of demonstrating​ nursing's skills. It is not a matter of values or​ attitudes; it is a practiced action. Resuscitation does not have a connection with boundaries.)

An experienced nurse is mentoring the new graduate. They talk about how exciting it was to see a successful Heimlich maneuver performed by a nursing colleague. How did that event promote the image of​ nursing? a It demonstrated nursing​'s values. b It demonstrated nursing​'s boundaries. c It demonstrated nursing​'s skills. d It demonstrated nursing​'s attitudes.

A. American Nurses Association's (ANA's) Code of Ethics This set of ethical principles provides the professional guidelines established by the ANA to maintain the highest standards for ideal conduct in practice. As a profession, the ANA wanted to establish rules and then incorporate guidelines for accountability and responsibility of each nurse within the practice setting.

Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: A. American Nurses Association's (ANA's) Code of Ethics B. Nurse Practice Act (NPA) written by state legislation C. Standards of care from experts in the practice field D. Good Samaritan laws for civil guidelines

a (Rationale The relationship that is being enhanced is that of nurses and coworkers. Other activities are more appropriate to enhance the relationships of nurses and​ people, practice, and the profession.)

Once a​ month, the nurses working in case management get together for a potluck lunch. They have found that this informal session promotes a sense of a united community. Which of the International Council of Nurses Code of Ethics​' relationships is being​ enhanced? a Nurses and coworkers b Nurses and the profession c Nurses and practice d Nurses and people

b, c, d, e

according to the american academy of pediatrics, which of the following developmental health screenings should be performed on a 24 month old child? select all that apply a. weight for length b. BMI c. head circumference d. autism screening e. behavioral assessment

a

autism can usually be diagnosed when the child is approximately: a. 2 years of age b. 6 years of age c. 6 months of age d. 1-3 months of age

c

a nurse is providing care for a client who was diagnosed with disruptive mood dysregulation disorder. the nurse should identify that which of the following findings supports the diagnosis? a. the client has autism b. the client is 5 years old c. the parents report frequent temper tantrums d. manic episodes alternate with periods of depression

a

a nurse is providing teaching for the parents of an infant with cerebral palsy. how will the nurse advise the parents to carry the infant in a sitting position to prevent scissoring of the legs? a. astride one of her hips b. strapped in an infant seat c. wrapped tightly in a blanket d. under the arm using a football hold

d

a nurse manager receives a report that one of the staff nurses might be chemically impaired. which of the following actions should the nurse manager take first? a. review the nurses work performance history b. complete a count of controlled substances on the unit c. talk with the staff members who reported the nurse d. remove the nurse from client care

a (Rationale: The nurse is aware that marijuana has been shown to be effective for a condition a client has that has not responded to mainstream therapies. Although the nurses' personal moral issues may be involved, the nurse must determine whether, ethically, the client should be made aware of a potentially effective alternative. Telling the patient that they shouldn't take drugs is inappropriate because, in this case, marijuana for medical use is legal. Refusing to provide the client information and referring the client to their doctor for information regarding therapy, are incorrect answers. )

A terminally ill client asks the nurse to provide her with information on medical marijuana use, which is legal in the state she lives in. Which is the best response by the nurse? a "Marijuana has been shown to be effective for certain conditions that have not responded to conventional therapy." b "You shouldn't take drugs." c "I cannot give you any information regarding that therapy." d "I will notify your physician regarding your desire for more information."

4 The most likely diagnosis is attention deficit/hyperactivity disorder because the child has the classic symptoms.

A 7-year-old child in a classroom is disruptive with loud talking, short attention span, difficulty organizing work, unable to finish assigned class work, and moodiness. Which of the following is the most likely diagnosis for this child? 1. Enuresis. 2. Sexual abuse. 3. Learning disability. 4. Attention deficit/hyperactivity disorder

4 This is an example of autonomy.

A 90-year-old male client was recently widowed after more than 60 years of mar- riage. The client was admitted to a long-term care facility and is refusing to eat. Which intervention is an example of the ethical principle of autonomy? 1. Place a nasogastric feeding tube and feed the client. 2. Discuss why the client does not want to eat anymore. 3. Arrange for the family to bring food for the client. 4. Allow the client to refuse to eat if he wants to.

4

A 90-year-old male client was recently widowed after more than 60 years of marriage. The client was admitted to a long-term care facility and is refusing to eat. Which intervention is an example of the ethical principle of autonomy? 1. Place a nasogastric feeding tube and feed the client. 2. Discuss why the client does not want to eat anymore. 3. Arrange for the family to bring food for the client. 4. Allow the client to refuse to eat if he wants to.

3 Allowing toddlers to participate in actions of which they are capable is an excellent way to enhance their autonomy.

A 3-year-old female is hospitalized for a femur fracture. As her nurse, what nursing action would help foster the child's sense of autonomy? 1. Allow the child to choose what time to take her oral antibiotics. 2. Allow the child to have a doll for medical play. 3. Allow the child to administer her own dose of Keflex (cephalexin) via oral syringe. 4. Allow the child to watch age-appropriate videos.

B. A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy. The ethical issue was the inequality of treatment based strictly upon racial differences. Secondly, the drug was deliberately withheld even after results showed that the drug was working to cure the disease process in the white men for many years. So after many years, the black men were still not treated despite the outcome of the research process that showed the drug to be effective in controlling the disease early in the beginning of the research project. Therefore harm was done. Nonmaleficence, veracity, and justice were not followed.

A bioethical issue should be described as: A. The physician's making all decisions of client management without getting input from the client B. A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy. C. The withholding of food and treatment at the request of the client in a written advance directive given before a client acquired permanent brain damage from an accident. D. After the client gives permission, the physician's disclosing all information to the family for their support in the management of the client.

a About​ 80% of all cases of CP are classified as spastic. The other types of cerebral palsy are less common.

A child is newly diagnosed with cerebral palsy​ (CP). For which type of cerebral palsy should the nurse most likely plan​ care? A. Spastic cerebral palsy B. Ataxic cerebral palsy C. Dyskinetic cerebral palsy D. Mixed cerebral palsy

a (rationale: When presented with an ethical situation, identify the moral issues and principles involved. The nurse should discuss the reasons the client does not want his wife to know the diagnosis. This will clarify the benefits the client sees in his decision. The other choices are disrespectful of the client's wishes, or imply something about the client that may not be true. )

A client asks the nurse not to tell his wife that he has cancer. What would be the most appropriate response by the nurse? a "What benefits do you see from not telling your wife your diagnosis?" b "Why are you afraid to tell her?" c "I'm sorry, but the doctor already told her." d "Don't you think she has a right to know?"

d Veracity is the principle behind giving complete information before obtaining a​ client's informed consent. Autonomy is the right of​ self-determination. Justice ensures fair treatment. Beneficence means taking action to promote​ good, but because the nurse has no experience with the new​ drug, it is not known whether it will be good for the client.

A client has a rare form of pancreatic cancer and qualifies to join a clinical trial of a new investigational drug. The nurse provides the client with complete risk information before the client signs up to become a research participant. Which principle of ethical decision making did the nurse​ honor? A. Justice B. Beneficence C. Autonomy D. Veracity

c (Rationale: Many moral problems surrounding the end of life can be resolved if clients complete advance directives. Currently, all 50 states have enacted advance directive legislation. Advance directives are legal documents representing a client's end-of-life decisions; they may include how clients want medical decisions to be made or whom they would like to make those decisions. An advance directive may include a DNR clause, but it is not mandatory. )

A client requests information on completing an advance directive. The nurse knows that an advance directive: a Must always include a Do Not Resuscitate (DNR) clause b Cannot be utilized as a legal document c Legal document representing a client's end-of-life decisions d Has been used in 35 of the 50 states in the United States

c (Rationale: To protect the client effectively, the nurse needs to understand what has influenced the client's decision and whether the client has thought about the results of the decision. The other choices do not respect the client's right to choose.)

A client with cancer has decided against further treatment. Which action by the nurse would be most appropriate? a Informing the client's spouse, and encouraging the spouse to talk to the client and intervene, if necessary. b Talking to the client and trying to persuade the client to think about reversing the decision. c Making sure the client has accurate information and understands the consequences of the decision. d Accepting the decision and making no comments to the client.

2 Cerebral palsy is not a genetic disease. It is caused by a hypoxic injury that can occur at any time during pregnancy, labor and delivery, or the postdelivery period.

A client's amniocentesis results were reported as 46, XY. Her obstetrician informed her at the time that everything "looks good." Shortly after birth the baby is diagnosed with cerebral palsy. Which of the following responses will explain this result? 1. It is likely that the client received the wrong amniocentesis results. 2. Cerebral palsy is not a genetic disease. 3. The genes that cause cerebral palsy have not yet been discovered. 4. The genetics lab failed to test for cerebral palsy.

c (Rationale: Some of the most frequent disturbing ethical problems for nurses involve issues that arise around death and dying. Nurses must learn to assist clients and families to discuss their options surrounding terminal care. It is appropriate for the nurse to provide the family opportunity to talk about their decisions. The family may wish to grieve on their own; however, the nurse must first assess to see if this is what the family requests. To notify the family of possible organ donation or to request the physician at the client bedside, is inappropriate. )

A family is struggling with the decision to remove life support on a child who was in a near-drowning accident. What is the best action for the nurse to take? a Allow the family to grieve on their own and only intervene if family requests. b Call the physician to be present at the client's bedside. c Provide the family opportunity to talk about their decisions. d Notify the family about the possibility of organ donation.

a (Rationale An ethical concern is best illustrated by issues related to whether the​ client's ability to pay should influence the plan of care. Standardizing blood tests for all potential candidates does not reflect an ethical concern. Including a​ client's family members in the teaching process is a principle of client education. Obtaining informed consent prior to a surgical procedure is a standard requirement.)

A team comprised of nurses and healthcare providers is collaborating to create a policy related to organ transplantation. Which team​ member's statement best represents an ethical​ concern? a ​"The client's ability to pay for treatment should influence the plan of​ care." ​b "Client teaching for potential organ transplantation candidates should include the​ client's family​ members." ​c "Potential candidates for organ transplantation should undergo blood​ tests." ​d "Clients who undergo organ transplantation must give informed​ consent."

1 ( Assess the patient for behaviors that would warrant seclusion (i.e., represent a danger to self or to others), then discuss your concerns with the provider. If seclusion is punitive, there is a potential for violation of rights, regardless of whether the order is verbal or written. Although patients do need limit setting and clear boundaries, you must intervene in the "least restrictive" manner. After additional assessment, you may decide that documentation, seclusion, and continued care are options. However, you may also decide that you need to go up the chain of command to prevent future similar incidents. Focus: Prioritization; QSEN: TC, QI; Concept: Ethics)

A health care provider verbally directs you to seclude Ms. M for several hours because "she was belligerent and argumentative" during an interview. You request a written order, but he declines because "it is just temporary and I already explained the consequences of the behavior to the patient." What is the best approach in dealing with this situation? 1. Assess the patient for signs of aggressive or dangerous behavior and discuss your findings and concerns with the provider. 2. Refuse to follow the verbal order because you are violating the patient's rights if you do not have a written order. 3. Recognize that setting limits and enforcing consequences are part of the treatment plan, so seclude and monitor accordingly. 4. Document the situation, seclude the patient, and continue to care for her to the best of your ability.

d (Rationale The nurse needs to check the​ client's status with the physiological measurements of vital signs. Making sure the client is not in pain is​ important, but not the priority clinical action. Informing the supervisor and the primary care physician can be done later. The client has a right to​ assessment, even with a DNR sign.)

A nurse in a​ long-term care facility finds a client unresponsive in bed. The nurse notices a do not resuscitate​ (DNR) sign at the head of the bed. What is the nurse​'s priority​ action? a Making sure the client is not in pain b Letting the physician know of the client​'s condition c Letting the supervisor know of the client​'s condition d Taking the vital signs of the client

a (Rationale: The ethical obligation to care for an HIV-infected client cannot be set aside unless the risk exceeds the responsibility. The nurse has an ethical obligation to care for the client regardless of the client's reason for contracting the disease. The nurse's religious beliefs are not a valid reason to decline to care for the client. There are many times when caring for a client may be distasteful, but the client has the right to be cared for by the nurse. )

A nurse is asked to care for an openly gay client with AIDS. The nurse tells her supervisor that caring for the client is against her religious beliefs. Does this nurse have an ethical obligation to care for the client? a Yes, unless the risk exceeds the responsibility. b No, because the client's behavior caused him to contract AIDS. c No, the nurse does not have to violate religious beliefs. d No, it may be distasteful to the nurse.

2 Baclofen is used to treat the spasticity in cerebral palsy. It is a centrally acting muscle relaxant.

A nurse is caring for a child with spastic cerebral palsy. Which of the following medications should be used for the treatment of spasticity? 1. Dexamethasone (Decadron). 2. Baclofen. 3. Diclofenac (Voltaren). 4. Carbamazepine (Tegretol).

a,c,d (Rationale Beneficence means the​ nurse's actions should promote​ good; nonmaleficence means the nurse should do no harm and safeguard clients. Telling the truth is about​ "veracity," rather than​ "beneficence." Being fair to all possible clients is about​ "justice," rather than​ "beneficence.")

A nurse manager is talking to the night shift staff about the ethical principles supporting education of their preoperative clients. The nurse manager uses the words​ "beneficence" and​ "nonmaleficence." Which statements define these two​ concepts? ​(Select all that​ apply.) a The actions that nurses take should safeguard clients. b The actions that nurses take should be fair to all possible clients. c The actions that nurses take should do no harm. d The actions that nurses take should promote good. e The actions that nurses take should involve telling the truth.

b (Rationale: Beneficence means "the actions one takes should promote good." A nurse teaching a class of adolescents is promoting the health and well-being of the community. Veracity is always telling the truth. The right to self-determination is autonomy. Nonmaleficence means to do no harm and safeguard the client.)

A nurse practices beneficence when teaching a class of adolescents about the risks of drinking and driving. Beneficence is best described as: a The right to self-determination b The actions one takes should promote good. c Always telling the truth d Do no harm and safeguard the client.

b (Nurses have a legal responsibility to report any professional whom they suspect of engaging in illegal, immoral, or unethical activities. Normally, the nurse making such a report will do so following established procedures at the facility at which the nurse is employed. Ignoring the co-worker's behavior is not only immoral, but illegal as well. Notifying the public health department is not a part of reporting via the chain of command. It is not professional for the nurse to speak to other co-workers regarding a colleague's behavior unless the co-worker is the person who the nurse must report these suspicions. )

A nurse suspects a co-worker of engaging in illegal, immoral, or unethical conduct. What is the appropriate action by the nurse? a Ignoring the co-worker's behavior b Following established procedures at the facility at which the nurse is employed c Notifying the public health department d Inform other co-workers of the nurse's suspicions

a The professional ethics code for nursing care aligns with the equal effort of care delivery to all clients despite differences in moral agreement between the client and the nurse. Refusal of​ care, purposeful delegation for the avoidance of​ care, and poor effort in equal care delivery do not align with the professional code of ethics for nurses.

A nurse whose brother was killed by a drunken driver is assigned to admit a client who has been in a car crash. The client is in police custody after being arrested for driving drunk for the third time. Which action on the part of the nurse aligns with the professional code of ethics for​ nurses? A. The nurse cares for the client in the same manner as for other clients. B. The nurse delegates all care of the client to an assistant. C. The nurse refuses care of the client. D. The nurse provides minimal care to keep the client alive.

4 The most valuable information the nurse can give the parents is how to prevent aspiration pneumonia from occurring in the future.

A pediatric client with severe cerebral palsy is admitted to the hospital with aspiration pneumonia. What is the most beneficial educational information that the nurse can provide to the parents? 1. The signs and symptoms of aspiration pneumonia. 2. The treatment plan for aspiration pneumonia. 3. The risks associated with recurrent aspiration pneumonia. 4. The prevention of aspiration pneumonia.

b,d,e (The values of​ autonomy, integrity, and altruism are three of the five essential values for the professional nurse to demonstrate. The other two are human dignity and social justice. Neither competence nor​ self-esteem are such values.)

According to the American Association of Colleges of​ Nursing, which values are essential for the professional nurse to​ demonstrate? ​ (Select all that​ apply.) ​a Self-esteem b Autonomy c Competence d Altruism e Integrity

a The best action by the nurse is to confirm the identity of the client and the​ client's contact information to see whether the friend is the emergency contact. If there is no way to confirm that the friend is related or should be​ contacted, there is nothing the nurse can do. The nurse would not notify the friend without the​ client's consent. The nurse should never post information about clients to social media.

An emergency department nurse is contacted by a friend whose father is a​ long-term care resident in a nursing facility that has had a fire. The friend describes the father and asks to be informed if he arrives in the emergency department. As those injured in the fire begin to​ arrive, the nurse spots a man matching the description given by the friend. Which action should the nurse​ take? A. Identifying the man and confirming his emergency contact B. Taking a picture of the​ man, posting it on social​ media, and tagging the friend C. Telling the friend that nothing can be done D. Calling the friend and saying that the father has arrived

a (Rationale The nurse must uphold the right of the client to​ privacy, even if the client is not an adult. The nurse cannot promise to disclose private information at a later time. The nurse cannot promise that the ED physician will disclose private information. The nurse also should not dismiss the concerns of the father.)

An emergency department​ (ED) nurse is approached by the parents of a teen admitted with a uterine hemorrhage. "Is my daughter ​pregnant?" the father asks. What is the most appropriate response by the nurse to the client​'s ​father? a "I cannot discuss her medical condition with you. All of our clients have privacy rights. b "I know this situation must be hard for you to deal with. I will let you know when I find out the answer. c "I don​'t think you have anything to worry about. She is a lovely young woman. " d "You can ask the admitting physician. I am sure he will discuss your daughter​'s condition with you.

c The older adult has the right to refuse​ treatment, and the nurse is legally and ethically bound to respect this decision. The client would not be discharged by the nurse for refusing the culture. Restraining the client so that the culture can be taken is against the law. The client is allowed to refuse treatment under blanket consent.

An older client without cognitive impairment refuses culture of a seeping wound. Which action should the nurse​ take? A. Asking the client about withdrawing blanket consent B. Discharging the client for noncompliance C. Respecting the​ client's decision D. Restraining the client so that the culture can be taken

b, c, e There is no specific diagnostic test for​ CP, but​ MRI, CT​ scan, and PET scan can be helpful in eliminating other organic brain​ disease, such as tumors or developmental issues. Electrocardiographic studies and laboratory studies are not used to diagnose CP.

An​ 18-month-old client is suspected of having cerebral palsy​ (CP). Which test should the nurse expect to be prescribed to help diagnose this​ client? (Select all that​ apply.) A. Laboratory studies of protein levels in the bloodstream B. MRI C. CT scan D. Electrocardiographic studies E. PET scan

d (Advocacy is based on the best interests of the clients. If they have made the decision to stop trying​ IVF, you support their decision. Telling about your own experience is not advocacy. Suggesting continuing treatment or talking about new developments is not advocacy in the face of the​ clients' decision to stop treatment)

As the newly hired nurse in the fertility​ clinic, you feel your own success with in vitro fertilization​ (IVF) makes you a unique resource for clients. This​ morning, Helena and Chad​ Smythe, both​ 39-year-old accountants, have a scheduled appointment. They have been to the fertility clinic for several years. Each time Helena and her husband find out that the IVF was not​ successful, her mood spirals downward. Helena and Chad tell you that they have decided to adopt a​ child, rather than have Helena continue to suffer from increasing depression.​ "My wife's mental health is so important to​ me," Chad relates. Helena nods in agreement. Which response would show that you understand the ethical value of​ advocacy? ​a "I would suggest that you try IVF one more time before you give​ up." ​b "I kept trying and waited for new developments in​ IVF." ​c"I would like to tell you about my experience with​ IVF." ​d "I understand why you​ don't want to continue with IVF and support you in that​ choice."

a (Carla's plan might violate the professionalism that calls for attention to boundaries with​ clients, by giving a client a personal gift.​ Carla's plan does not affect her attention to professional appearance and demeanor.​ Carla's plan does not violate her pursuit of professional engagement. And her plan does not violate her articulation of​ nursing's professional skills.)

As the night nurse on the obstetrics​ unit, Carla has gotten to know one client very well. Sarah Gomez is a​ 42-year-old elementary teacher. Ms. Gomez was confined to her bed for an extended​ time, and Carla has found that they know people in common. Ms. Gomez had a successful​ C-section. Now that she is about to be discharged​ home, Carla plans to bundle up her own unused newborn clothes to give to Ms. Gomez as a gift. What professional behavior associated with ethical nursing values might​ Carla's plan​ violate? a Attention to professional boundaries with clients b Attention to professional appearance and demeanor c Articulation of​ nursing's professional skills d Pursuit of professional engagement

b Infants and children with CP do not exhibit normal muscle tone. Infants with cerebral palsy often exhibit arching of the back. Children with CP often experience delay in reaching developmental milestones. Strabismus is seen in children with CP.

A​ 1-year-old child is being evaluated for cerebral palsy​ (CP). Which finding should the nurse least expect to assess in this​ client? A. Developmental delay B. Normal muscle tone in all extremities C. Strabismus D. Arching of the back

b The child with CP most likely has been evaluated and treated by a physical therapist who developed a plan for tendon stretching and​ range-of-motion exercises to decrease the rigidity and spasticity. This plan should be shared with the school nurse. Most school districts do not require that children with physical disabilities such as those associated with CP attend alternative schools. Children with CP require​ high-calorie foods because of feeding difficulties associated with spasticity and hypotonia. Computers are encouraged to promote communication.

A​ 6-year-old child with cerebral palsy​ (CP) new to a school district is experiencing severe rigidity and spasticity. What should the school nurse say to the​ parents? A. ​"Offer only​ low-carbohydrate, low-calorie foods to the​ child." B. ​"What exercises can we do during school to help with the​ rigidity?" C. ​"Discourage the use of a​ computer." D. ​"Look into special schools for the​ handicapped."

b Providing​ large, padded utensils makes​ self-feeding easier and facilitates success with this endeavor. Children with CP should be encouraged to do as much as they can for themselves. Insisting on total feeding or not allowing prolonged periods of time to practice​ self-feeding does not help encourage independence.

A​ 7-year-old client with cerebral palsy​ (CP) is learning to​ self-feed. Which action should the nurse encourage to promote independence and success with​ self-feeding? A. Restricting attempts at​ self-feeding to 5 minutes B. Providing​ large, padded eating utensils C. Reassuring the child that having to be fed is nothing to be ashamed of D. Assisting the parents with total feeding

c, d, e Most cases of CP are caused before or during birth by a brain​ insult; this includes premature​ birth, fetal viral​ infection, and injury to the cerebral cortex. CP can also develop after birth to age 2​ years, when it can be caused by neonatal sepsis and hyperbilirubinemia.

A​ small-for-gestational age neonate is showing signs of poor development. Which factor should the nurse identify that increases this​ client's risk of cerebral palsy​ (CP) before or during​ birth? (Select all that​ apply.) A. Neonatal sepsis B. Hyperbilirubinemia C. Premature birth D. Fetal viral infection E. Injury to the cerebral cortex

a,d (Rationale With regard to ethical​ dilemmas, nursing responsibilities include recognizing the actual or potential ethical​ dilemma; informing the client and care team members of ethical issues affecting the​ client's care; always adhering to the ANA Code of Ethics for registered​ nurses; managing ethical​ challenges; and evaluating the outcomes of interventions taken to promote ethical practice. The nurse is not responsible for ensuring that ethical challenges do not occur.)

During a continuing education​ meeting, the nurse educator is discussing the nurse​'s responsibilities related to ethical dilemmas. Which statements should the nurse educator include in the​ presentation? ​(Select all that​ apply.) a "Notifying care team members about ethical challenges is the nurse​'s responsibility. b "The nurse should ask the healthcare provider to manage ethical challenges that emerge during client care. " c "It is the nurse​'s responsibility to ensure that ethical challenges do not arise during the client​'s care. " d "Informing the client about ethical issues that affect the client​'s care is part of the nurse​'s job. e "Whenever ​possible, the nurse should adhere to the ANA Code of Ethics for nurses.

a, b, d, e Abnormalities that can be assessed that indicate cerebral palsy include asymmetric​ crawling, head​ lag, arched​ back, and poor trunk control. Thumb sucking is not a manifestation of CP.

During an​ assessment, the nurse suspects that an​ 18-month-old client is demonstrating manifestations of cerebral palsy​ (CP). Which assessment finding should the nurse use to validate this​ conclusion? (Select all that​ apply.) A. Poor trunk control B. Head lag C. Thumb sucking D. Asymmetric crawling E. Arched back

a,e (Rationale Each nurse might be operating with a different set of assumptions about pain relievers. Where one sees pain​ relief, the other might see addiction potential. Neither nurse has better personal ethical values. The client should be helped to make an informed decision about pain relief measures. This education should not include scaring the client about overdosing.)

During​ change-of-shift report, two​ medical-surgical nurses are discussing the pain management situation of a client with a low tolerance for pain. Giving repeated large doses of pain relievers bothered the evening shift​ nurse, but not the day shift nurse. Which statements about ethical client care are relevant in this​ situation? ​ (Select all that​ apply.) a The client should be helped to make an informed decision about pain relief measures. b The evening shift nurse has better personal ethical values about pain relief. c The client should be warned about the dangers of overdosing on pain relievers. d The day shift nurse has better personal ethical values about pain relief. e Each nurse might be operating with a different set of assumptions about pain relievers.

c (The​ client's needs conflict with the desires and needs of his​ family, as well as his healthcare​ provider's recommendation. Even​ so, according to the ANA Code of Ethics for​ Nurses, the​ nurse's first loyalty is to the client. As​ such, the nurse should honor the​ client's wishes and decline his​ family's requests to visit with him.)

Erin Klarke is a staff nurse in a secured critical care unit. Her​ client, Stu​ Willitson, is a​ 58-year-old man who sustained multiple injuries during a motor vehicle accident. Mr. Willitson​ states, "I​ don't want my​ wife, kids, or any other family or friends in my room. I​ don't want them to see me like​ this." Mr.​ Willitson's wife has tearfully asked Erin to allow her and her children to see her​ husband, and her children are demanding to see their father. Mr.​ Willitson's healthcare provider told him he is being unreasonable and insists he see his family. According to the ANA Code of​ Ethics, which action by Erin is the most​ appropriate? a Encourage the client to allow his wife and children to briefly visit with him to reassure them that he is okay. b Encourage the client to allow his wife to see him​ first, and advise the wife to suggest visiting with the children. c Support the client in his decision and encourage him to explore the reasons for his choice. d Support the healthcare​ provider, and encourage the client to explore the reasons for his unreasonable behavior.

b (The nurse must honor competent and informed​ clients' decisions to refuse food and fluids. The ANA Code of Ethics for Nurses supports this position through defining the​ nurse's role as a client advocate and through the moral principle of autonomy. The client has the right to refuse food and fluids. Refusal or withdrawal of one or more treatments does not mean cessation of client care.)

Gerald​ DeMarco, a hospice​ nurse, is caring for Alyce​ Greinberg, a​ 38-year-old woman whose pancreatic cancer has spread throughout her body. Although Ms. Greinberg has refused all medical​ treatments, she has been eating and drinking normally and remains alert and oriented. During​ Gerald's most recent​ visit, Ms. Greinberg declined her meal and​ stated, "I'm not eating or drinking anymore.​ I'm ready to​ die." What is the most appropriate action for Gerald to take at this​ time? a Notify the​ client's family members and ask them to encourage the client to take some nutrition. b Honor the​ client's wishes and encourage her to verbalize her feelings and concerns. c Respect the​ client's choice and explain that refusal of nutrition is grounds for termination of care. d Obtain a medical order to administer intravenous fluids to the client.

b,c (The nurse would turn to the state board of nursing or the American Nurses Association for guidance regarding the behavior of a​ co-worker. Nursing school would not be an official resource. The National Alliance on Mental Illness is an advocacy program. The nurse would not initiate consultation with the police dash- this would be done by the employer.)

In deciding to report a​ co-worker who has engaged in​ illegal, immoral, or unethical​ conduct, the nurse can turn to which organizations for​ guidance? ​(Select all that​ apply.) a The National Alliance on Mental Illness b The American Nurses Association c The state board of nursing d Nursing school e The police

c (Jose's ignoring his​ doctor's advice to exercise regularly may indicate unclear values. Looking forward to the birth of his grandchild is a clear family value. Having a family history of heart disease is a genetic​ risk, not a behavior. Loading a palette quickly is a career value.)

Jose Cardena is a​ 48-year-old warehouse worker who has been admitted to the cardiology unit because of chest pain. He has a strong family history of heart attacks before age 50. You are the nurse manager on the cardiology​ unit, and Jose tells you that he​ "can load a pallet faster than men half my​ age." He and his wife Trina are expecting their first grandchild in 3​ months, and Jose is already thinking about names for the new baby. His doctor has advised him to begin a program of regular​ exercise, but Jose counters that he does not need to do​ that, saying​ "I'm already​ strong!" Which of​ Jose's behaviors may indicate unclear​ values? a Loading a pallet faster than anyone else b Looking forward to the birth of his grandchild c Ignoring his​ doctor's advice to exercise regularly d Having a family history of heart disease

c (Staffing shortages represent a critical​ concern, as numerous studies link staffing levels to safe client care. Personnel issues can give rise to ethical conflicts in the​ nurse's workplace. Due to increasingly stringent cost containment​ methods, resource limitations are especially urgent issues. Another source of ethical conflict is the traditional healthcare power​ structures, including focusing on providing curative treatment and emphasizing the healthcare​ provider's role.)

Matthias McPherson is a nursing student at a local university. During a seminar about ethics and​ nursing, the nurse educator asks Matthias to describe an issue that may lead to ethical conflict in the workplace. Which response indicates an issue that may lead to an ethical​ conflict? ​a "Personnel issues are not a valid source of ethical conflict because they are usually rooted in personality​ clashes." ​b "Focusing on palliative treatment and emphasizing the​ nurse's role leads to ethical conflicts in​ nursing." ​c "Staffing shortages are a critical ethical concern because research shows a link between staffing and safe client​ care." ​d "Because of more stringent cost containment​ methods, allocating resources is becoming a less urgent ethical​ issue."

d (Rationale The nurse is morally obliged to support the​ client's right to make his own healthcare decisions. The healthcare​ providers' may advise the client about best​ options, but may not make decisions for the client. The hospital does not have authority to make decisions for the client. The nurse must respect the​ client's culture and​ traditions, even if they create conflict with the​ nurse's own beliefs and values.)

The new nurse observes that her client is becoming upset with his healthcare providers because they disagree with the client​'s decision to discontinue his cancer treatment. Although the nurse feels conflicted by the client​'s ​decision, which moral obligation guides the care that is provided to the​ client? a The nurse explains to the client that he is making a mistake because his culture and traditions are leading him down the wrong path. b The nurse must defend the healthcare providers​' choice to continue cancer therapy because that is what is best for the client. c The nurse respects that the hospital has the final authority to make decisions for the client. d The nurse supports the client​'s right to make his own healthcare decisions.

2 The ethical principle of veracity is the duty to tell the truth.

The night nurse walks into the client's room and finds the client crying. The client asks the nurse "Am I dying? I think something bad is wrong but they aren't telling me." The nurse knows the client has cancer and has less than 6 months to live. Which response is an example of the ethical principle of veracity? 1. "You are concerned they are not telling you something is wrong." 2. "I am sorry to tell you but you have cancer and less than 6 months to live." 3. "If you think something is wrong you should speak with your doctor in the morning." 4. "What makes you think there is something wrong and you are dying?"

d (Active euthanasia involves taking actions to directly cause a​ client's death, with or without client consent. Regardless of the​ caregiver's intent, active euthanasia is illegal and can result in criminal charges against the individual who causes the​ client's death. Assisted​ suicide, which is a variation of active​ euthanasia, involves giving clients the means to kill themselves if they request it. Some countries —as well as some states in the United States —have laws permitting assisted suicide for severely ill clients who are near death and who wish to commit suicide.)

The novice nurse asks the nurse preceptor to define active euthanasia. Which response is​ best? a "It may involve providing a client with medications or a weapon. b "It is the same thing as assisting a client with suicide. c "It is legal in some countries and in some states within the United States. " d "It can involve directly causing death without client consent.

a,c,d (Rationale ​Altruism, autonomy, and integrity are nursing values identified by the AACN. Efficiency and effectiveness are not values chosen by the AACN.)

The novice nurse has accepted a​ medical-surgical position after passing the boards and wants to work for an organization that acknowledges the values of the nursing profession. Which values outlined by the organization are consistent with those identified by the American Association of Colleges of Nursing​ (AACN)? ​ (Select all that​ apply.) a Integrity in dealing with clients and​ co-workers b Effectiveness in the new job c Altruism when dealing with other nurses d Autonomy on behalf of self e Efficiency when dealing with clients

b (Rationale: Medication errors do occur and the nurse is ethically bound to report these errors, regardless of whether the client had an adverse reaction or not. The nurse would notify the charge nurse of the mistake, who would document the error on an incident report, not in the patient's chart. Notifying the Board of Registered Nursing is not the nurse's responsibility, but the agency may be notified if the nurse's supervisor deems the mistake incompetent in nature. )

The nurse administers the wrong medication to the client and the client appears to have had no adverse reaction to the medication error. What is the best action for the nurse to take once she realizes her mistake? a Notify the Board of Registered Nursing. b Notify the charge nurse. c Document the error in the patient chart. d Reporting the incident is not necessary because the patient had no adverse reaction.

b, c, d To rule out medical causes for behavior in a suspected ASD​ client, the healthcare provider should order a CT scan or​ MRI, DNA​ analysis, lead​ screening, and electroencephalography. A KUB​ x-ray is a radiograph of the​ kidneys, ureters, and bladder. ABGs are arterial blood gases and are used to measure the amounts of oxygen and carbon dioxide in the blood. They are not used to rule out ASD

The nurse admitting a child who is suspected of having autism spectrum disorder​ (ASD) knows that it is necessary to rule out medical causes for the​ child's behavior before diagnosing ASD. Which diagnostic test should the nurse anticipate will be ordered for the​ client? (Select all that​ apply.) A. KUB​ x-ray B. DNA analysis C. Electroencephalography D. CT scan E. ABG

a, b, d Behaviors indicative of ASD include stereotypy​ (rigid and obsessive​ behavior), echolalia​ (the compulsive parroting of a word or phrase just stated by​ another), and an aversion to being touched. Emotional lability​ (rapid, significant mood​ changes), not emotional​ calm, is a clinical manifestation of ASD. ASD does not manifest in any physical signs.

The nurse assesses a child suspected of having autism spectrum disorder​ (ASD). Which behavior noted in the assessment supports the​ diagnosis? (Select all that​ apply.) A. Echolalia B. Stereotypy C. Emotional calm D. An aversion to being touched E. Deep set eyes

a Under the principle of​ accountability, the nurse is responsible for the outcomes of care rendered and the care given by trainees and subordinates. Fidelity is faithfulness to an agreement. Beneficence is the act of doing well. Nonmaleficence is the avoidance of causing harm.

The nurse delegates vital signs to an unlicensed assistive personnel​ (UAP). The UAP reports the vital signs to the​ nurse, which indicate hypotension and bradycardia. The nurse then assesses the client. Which moral principle is exhibited by the​ nurse? A. Accountability B. Nonmaleficence C. Fidelity D. Beneficence

d Staffing shortages represent a critical​ concern; many studies link adequate staffing and safe client care. Personnel issues can give rise to ethical conflicts in the nursing workplace. Because of increasingly stringent​ cost-containment methods, resource limitations are especially urgent issues. Another source of ethical conflict is the traditional healthcare power​ structure, including the focus on providing curative rather than palliative treatment and emphasizing the healthcare​ provider's role.

The nurse delivering a seminar about ethics and nursing asks the audience to describe an issue that could lead to ethical conflict in the workplace. Which response indicates an issue that may give rise to an ethical​ conflict? A. ​"Focusing on palliative treatment and emphasizing the​ nurse's role leads to ethical conflicts in​ nursing." B. ​"Personnel issues are not a valid source of ethical conflict because​ they're usually rooted in personality​ clashes." C. ​"Because of more stringent​ cost-containment methods, allocation of resources is becoming a less urgent ethical​ issue." D. ​"Staffing shortages are a critical ethical concern because research shows a link between staffing and safe client​ care."

a,d,e (Rationale The scenarios that best illustrate opportunities to advocate for the​ client's autonomy include disagreement from family members about the​ client's choices, healthcare providers who fail to hear the​ client's concerns, and lack of spousal support for the​ client's refusal of care. Family​ members' requests to access the​ client's information and computerization of the​ client's healthcare record best illustrate scenarios in which the nurse must preserve confidentiality and​ privacy, which pertain to protecting the​ client's personal information from unnecessary or unauthorized access by others.)

The nurse educator is describing the application of moral principles in nursing practice. Which scenarios best illustrate opportunities for the nurse to serve as an advocate for the​ client's autonomy? ​(Select all that​ apply.) a Healthcare providers who fail to hear the client​'s concerns b Institutional computerization of the​ client's records c Family members who request access to the​ client's health information d Lack of spousal support for the​ client's refusal of care e Disagreement from family members about the client​'s choices

b,c (Rationale Sources from which ethical conflicts in nursing may arise include staffing shortages or other situations that impact organizational​ efficiency, as well as traditional power structures in health​ care, including the focus on providing curative treatment. Ethical challenges also may stem from nurses functioning as open double quote"​in-betweens,close double quote" during which nurses are caught in between various players including healthcare providers and the​ client, the client and the​ client's family​ members, colleagues, and others.)

The nurse educator is leading a class discussion about factors that affect the nurse​'s function as a moral agent. When discussing potential sources of ethical​ challenges, which students​' statements are most​ accurate? ​ (Select all that​ apply.) a "Staffing shortages have little to no effect on creating ethical conflict. " b "Issues that impact organizational efficiency can create ethical conflict. " c "Typical power structures in health care can be sources of ethical conflict. " d "The traditional focus on palliative treatments can create ethical conflict " e "Functioning as an ​'​in-between​' helps to prevent ethical conflict. "

d (Rationale Assisted​ suicide, which is a variation of active​ euthanasia, involves giving clients the means to kill​ themselves, if they request it. Examples of assisted suicide include providing a client with medications or a weapon. Some countrieslong dash—as well as some states in the United Stateslong dash—legally allow assisted suicide for severely ill clients who are near death and who wish to commit suicide. Even​ so, the​ ANA's position statement on assisted suicide states that nurses who perform active euthanasia or who participate in assisted suicide are in violation of the ANA Code of Ethics for Nurses. Euthanasia may include administering a lethal dose of medication to end a​ client's suffering. Active euthanasia involves taking actions to directly cause a​ client's death, with or without client consent.)

The nurse educator is teaching about ethical dilemmas related to​ end-of-life issues. When discussing assisted​ suicide, which statement is appropriate for the nurse educator to​ include? ​a "Assisted suicide includes administering a lethal dose of medication to end a​ client's suffering." b ​"Assisted suicide is illegal throughout the entire United​ States." ​c "Assisted suicide involves taking actions to directly cause​ death, with or without client​ consent." ​d "Assisted suicide is a variant form of active​ euthanasia."

a (Rationale: The moral principle of veracity refers to telling the truth, no matter the outcome. By lying, the nurse jeopardized the health of the client. Human dignity includes the belief of the inherent worth of the client. Autonomy is the right to self-determination. Social justice is the upholding of rules of equal treatment for all clients. )

The nurse hung a unit of blood on the wrong client, resulting in an anaphylactic reaction in the client. During the resuscitation, the nurse does not reveal that the wrong blood was given. Which moral principle was absent in the nurse's actions? a Veracity b Human dignity c Autonomy d Social justice

a Social justice is the equal treatment of all clients without regard to cultural or socioeconomic​ background, ethnicity,​ gender, religion,​ disability, or sexual orientation. Altruism is a concern for the welfare of others. Integrity is practicing in an honest and ethical manner. Autonomy is supporting the independent decision making of others.

The nurse in the emergency department greets and treats a variety of clients with the same level of care. Which professional nursing value is demonstrated by this​ nurse? A. Social justice B. Autonomy C. Altruism D. Integrity

a Fidelity is a faithful agreement or​ promise, which has been broken in this situation. Justice is equal treatment of all clients. Veracity is​ truth-telling. Autonomy is respecting the​ client's decision making.

The nurse promises to bring a client a requested hand​ towel, but an hour​ later, the nurse has not returned. Which moral principle has this nurse​ violated? A. Fidelity B. Autonomy C. Veracity D. Justice

b The nurse has both moral and legal obligations to act on suspected or confirmed abuse and would follow the applicable law to report suspected domestic violence. The immediate action is any step indicated by state​ law, not necessarily calling the police immediately. The nurse would investigate the bruising with the significant other away from the bedside before releasing the client. The nurse would not break the confidentiality of the​ client's medical information by discussing findings with the significant other.

The nurse is caring for a client with a broken arm. On​ assessment, the nurse notes bruising that is not consistent with the story of a fall presented by the client. The client is withdrawn when the​ client's significant other comes to the bedside. Which action should the nurse​ take? A. Calling the police B. Following legal reporting obligations for suspected domestic violence C. Completing the discharge and releasing the client D. Asking the significant other about the cause of the bruising

b, d, e The nurse should protect bony prominences and assess regularly for redness and skin breakdown under the braces. The​ client's inability to change positions independently also places her at risk for pressure wounds and muscle contractures. Fatigue results from the extended energy needed to work against the muscle contractures. Atherosclerosis is a severe problem with CP that is associated with aging but is not caused by the leg braces or immobility. Dental caries are also unrelated to the braces or physical dependence.

The nurse is caring for a client with cerebral palsy​ (CP) who wears bilateral leg braces and requires full assistance to mobilize. For which condition is the client at​ risk? (Select all that​ apply.) A. Atherosclerosis B. Fatigue C. Increased dental caries D. Muscle contractures E. Pressure injuries

d Communication: Verbal, Impaired is an appropriate nursing diagnosis for a client with ASD. ​Macrocephaly, Risk for is not a nursing diagnosis. The client with ASD is not at risk for infection or ineffective airway clearance.​ (NANDA-I ©2014)

The nurse is developing a plan of care for a client diagnosed with autism spectrum disorder​ (ASD). Which nursing diagnosis is most appropriate for the nurse to​ include? A. Airway​ Clearance, Ineffective B. ​Macrocephaly, Risk for C. ​Infection, Risk for D. ​Communication: Verbal, Impaired

b, c, d, e Depending on state​ law, minors may obtain birth​ control, prenatal​ care, substance abuse​ counseling, and treatment for sexually transmitted diseases without parental consent. Parental consent is required for the​ long-term care of asthma.

The nurse is discussing consent for care with a​ 16-year-old client who does not want to involve the parents in care. For which health condition may the minor seek care without parental​ consent? (Select all that​ apply.) A. Asthma B. Prenatal care C. Sexually transmitted infections D. Birth control E. Substance abuse

a, b, c, d Autonomy, cognitive​ decline, depression, and understanding of the risks and benefits of treatment are common ethical issues in​ end-of-life care. Financial status is not included.

The nurse is discussing ethical​ end-of-life care of an older adult client with the interdisciplinary team. Which issue of care should the nurse include in the​ conversation? (Select all that​ apply.) A. Risks and benefits of treatment B. Cognitive impairment C. Autonomy D. Presence of depression E. Ability to pay for care and funeral expenses

a (According to The Joint​ Commission, clients have the right to know if something goes wrong with their care. The Joint​ Commission's patient rights require that client complaints of pain be​ addressed, but do not specify particular methods of treatment. Refusal of care is a client right and does not nullify the​ client's other rights. The client should be aware of who is providing care​ (RN, LPN,​ UAT, NP,​ MD), but not their level of education.)

The nurse is explaining The Joint Commission​'s patient rights to the client. Which statement by the nurse is the most​ accurate? a "If something goes wrong with your​ care, you have the right to know about it. b "The client must know the educational level of HCP's " c "You have the right to receive pain medication if you are experiencing pain. d "If you refuse​ care, the list of client rights no longer applies to you.

b,c,d,e (Rationale The decision to discontinue life support for any client is handled by the healthcare​ system, particularly its risk management and legal departments along with the family of the client. Principles of medical ethics and legal issues guide the​ decision-making process and are intended to protect the​ client's rights and the healthcare​ system's interests. Culture and diversity considerations address the values and beliefs of the client and family. Rehabilitation nursing would not be employed in an​ end-of-life scenario.)

The nurse is involved in the case of a minor client who is placed on life support after complications during surgery left her without neurologic function. The client​'s parents have retained legal counsel to prevent the hospital from discontinuing life support. Which advocacy concepts must be considered when communicating with the client​'s ​family? ​(Select all that​ apply.) a Rehabilitation nursing b Legal issues c Healthcare systems d Medical ethics e Culture and diversity

c Utilitarianism aims to provide the most good for the greatest number of​ people, which is exemplified here by the provision of vaccinations to children. Investing the money is a​ high-risk option with unknown benefit. Covering expenses for a single client and supporting the relationship with the​ donor's family do not benefit the largest number of people.

The nurse is part of a committee charged with the moral dilemma of deciding how to spend a​ $50,000 donation from the estate of a former client. Which action on the part of the committee demonstrates​ utilitarianism? A. Building a new front entrance named for the donor to support the relationship with the family B. Covering the medical expenses of a single client who cannot afford the needed treatment C. Securing vaccination stock to provide​ no-cost vaccines to approximately​ 2,000 children D. Investing the donation in a​ high-risk stock to attempt to increase the money available

c An appropriate goal when providing care to a client diagnosed with ASD is for the client to display developmental progress. Other appropriate goals include the client remaining free of​ injury, the client demonstrating positive communication​ skills, and the client participating in activities with family members or small groups of peers.

The nurse is planning care for a client who is diagnosed with autism spectrum disorder​ (ASD). Which goal is appropriate for the nurse to​ include? A. The client will engage in private activities to stimulate learning. B. The client will remain free from infection. C. The client will display developmental progress. D. The client will demonstrate negative communication skills.

a,b,e (Rationale Support systems that are useful to nurses who work in settings where ethical issues arise frequently include regular team conferences on subjects selected by the​ team, easy access to the use of counseling​ professionals, and availability of mentoring by experienced nurses. Protocols for advanced directives support​ evidence-based practice and primary nursing teams help to facilitate continuity of​ care, but they do not support the staff who works in an environment with frequent ethical issues.)

The nurse manager in the assisted living facility is finding that ethical issues arise frequently in this setting. The nurse manager empowers the entire clinical team to make suggestions for support activities. Which suggestions by the staff nurses are relevant to ethical​ issues? ​ (Select all that​ apply.) a Regular team conferences on subjects selected by the team b Availability of mentoring by experienced nurses c Use of primary nursing teams to facilitate care d Protocols for advanced directives for dying clients e Easy access to the use of counseling professionals

a, c, d, e The nurse manager can use the framework from risk management to help combat the impact of ethical issues in the workplace. This includes modeling coping​ behaviors, planning education​ sessions, creating a support​ network, and acquiring resources. The nurse manager would want to encourage the nurses to spend free time away from the unit as a means of relieving pressure.

The nurse manager is concerned about how the stress of ethical dilemmas is affecting the nurses of the unit. Which intervention should the nurse plan for the staff to help them cope with ethical​ dilemmas? (Select all that​ apply.) A. Acquiring resources to ease the impact of future stressors B. Encouraging time at the bedside to foster immersion in the dilemma C. Modeling coping behaviors D. Planning education for coping E. Creating a network for peer support

a Parents require emotional support to help them cope with the diagnosis. Listen to the​ parents' concerns and encourage them to express their feelings and ask questions. The nurse should encourage the family to ask questions and should obtain answers to questions that the nurse is unable to answer. All children with CP are not eventually transferred to a​ long-term care​ facility; many are successfully cared for at home. Referrals for individual and family counseling are​ appropriate, but the nurse is not qualified to suggest a referral for marriage counseling.

The nurse notes a high level of stress between the parents of a child with cerebral palsy​ (CP). Which action should the nurse take to support the​ parents? A. Listen to concerns and encourage expression of feelings B. Make a referral for marriage counseling C. Refer all medical questions to the healthcare provider D. Explain that all children with CP are eventually placed in​ long-term care facilities

d These issues all influence the running of an organ transplantation​ program, but the primary ethical concern of organ transplantation is the lack of donor organs for those who need​ transplants, leading to difficulty in ethical decision making regarding who should receive these precious resources

The nurse on an organ transplant unit is saddened by the death of a client and reflects on the many issues surrounding organ transplantation. Which issue is the nurse most likely to identify as the primary ethical concern in organ​ transplantation? A. The high risk of transplantation surgery B. The nursing shortage C. The cost of organ transplantation D. The lack of organs for those needing transplantation

1 Nonmalfeasance is the duty to prevent or avoid doing harm. The nurse asking not to be assigned to the NICU because of lack of experience in caring for critically ill infants is supporting the ethical principle of nonmalfeasance.

The nurse on the rehabilitation unit is being sent to the neonatal intensive care unit (NICU) to work because the unit is short-staffed. The nurse has never worked in the NICU. Which response by the nurse supports the ethical principle of nonmalfeasance? 1. The nurse requests not to be floated to the NICU. 2. The nurse accepts the assignment to the NICU. 3. The nurse asks why another nurse can't go to the NICU. 4. The nurse talks another nurse into going to the NICU.

b (Rationale:The U.S. Advisory Commission on Consumer Protection addresses the client's right to choose a healthcare plan. The ANA Code of Ethics determines the practice ethics of nurses. State laws are enacted from federal laws. Medicare does not have a bill of rights. )

The nurse overhears a client on the phone arguing with someone about having the right to choose a healthcare plan. The nurse recognizes that the client's topic is addressed in: a State law b U.S. Advisory Commission on Consumer Protection c Medicare bill of rights d The ANA Code of Ethics

b (Rationale An ethical dilemma exists when two or more​ rights, obligations,​ responsibilities, or values come in conflict. The nurse whose religious beliefs prohibit the use of contraception who is caring for a client that is seeking birth control best reflects a potential ethical dilemma. Ethical beliefs that prohibit eating meat are congruent with​ vegetarianism, supporting the right to abortion is congruent with considering terminating a​ pregnancy, and valuing free will and independence is congruent with autonomy.)

The nurse preceptor asks the nursing student to give an example of a potential ethical dilemma. Which example given by the nursing student reflects an ethical​ dilemma? a "A client who values free will and independence is cared for by a nurse who promotes the client​'s right to autonomy. " b "A nurse whose religious beliefs prohibit the use of contraception is caring for a client that is seeking birth control. " c A client whose ethical beliefs prohibit eating meat is seeking nutritional counseling from a nurse who is a vegetarian. " d "A nurse who supports the client​'s right to have an abortion is caring for a client who is considering terminating her pregnancy. "

d (Nursing responsibilities with ethical dilemmas include informing the client and care team members of the ethical issues affecting the​ client's care. The nurse should always adhere to an appropriate code of​ ethics, should recognize actual or potential ethical​ dilemmas, and evaluate the outcomes of interventions taken to promote ethical practice.)

The nurse preceptor is explaining the nurse​'s responsibility with regard to ethical dilemmas. Which statement should be​ included? a "Evaluating interventions taken to promote ethical practice is the nurse unit manager​'s responsibility. " b "The nurse should try to​ follow, when​ possible, an appropriate code of ethics for registered nurses. c "Avoiding actual or potential ethical dilemmas is a primary responsibility of the nurse. d "The nurse must tell the client and the healthcare team about ethical issues that may affect the client​'s care.

b (Rationale In application of the primary risk management​ model, peer support and consultation are combined to create resources that emphasize primary prevention of ethical challenges. Resource accumulation involves acquiring the needed resources and coping skills prior to experiencing the stressor.​ Education, which should always be combined with didactic​ training, is used to create an additional resource for developing primary risk management skills.)

The nurse researcher is presenting a webinar about the application of the primary risk model for managing ethical dilemmas in nursing. When describing peer​ support, which statement is most​ accurate? ​a "Peer support involves developing secondary risk management​ skills." ​b "Peer support should be combined with consultation to prevent ethical challenges from​ arising." ​c "Peer support involves acquiring the necessary coping skills prior to experiencing the​ stressor." ​d "Peer support should be combined with didactic training for maximum​ effect."

1, 2, 3

The nurse tells the parent that other conditions can be associated with congenital clubfoot? Select all that apply. 1. Myelomeningocele. 2. Cerebral palsy. 3. Diastrophic dwarfism. 4. Breech position in utero. 5. Prematurity. 6. Fetal alcohol syndrome.

a (Rationale When the nurse has to make​ challenging, but​ fair, decisions related to the allocation of scarce​ resources, the principle of justice prevails. This situation does not call for​ autonomy, veracity, or beneficence.)

The nurse working in an allergy clinic finds that the clinic did not receive enough vials of flu vaccine this year. The nurse devised a decision tree to identify priority clients who have the greatest need for the flu vaccine. Which primary principle guided the nurse​'s ethical decision​ making? a Justice b Veracity c Beneficence d Autonomy

b (Rationale: The nurse must become aware of personal values and the ethical aspects of nursing. The nurse must collaborate with other members of the healthcare team. When values conflict, compromise is essential. The nurse might have the charge nurse administer the medication. Nurses must not impose personal values and beliefs on their clients. )

The nurse, who is opposed to abortion, is asked to give a medication to the client that will terminate the client's pregnancy. Which strategy might help the nurse in this case? a Refuse to participate in the collaboration regarding this client. b Have self-awareness of values and beliefs. c Withhold the medication until the prescribing person arrives. d Tell the client that taking the medication is immoral.

a,b,c,d (Rationale Organs for transplantation may be harvested from owners who have just died or from living donors. Ethical conflicts related to organ transplantation are client specific and may stem from a variety of​ concerns, including religious beliefs that forbid body mutilation for any​ reason, allocation of​ organs, and involvement of children both as potential donors and recipients.)

The nursing director of surgical services is preparing an​ in-service about client care protocols related to organ transplantation. Which situations best reflect potential sources of ethical​ conflict? ​ (Select all that​ apply.) a Children as potential organ donors b Children as potential organ recipients c Allocation of organs d Religious beliefs e Harvesting organs from living donors

d (Rationale Staffing​ shortages, resource​ allocation, specialists'​ services, and cost containment are all potential sources of ethical conflict in the healthcare setting.​ However, staffing shortages represent a critical​ concern, as numerous studies link staffing levels to safe client care.)

The nursing student is writing a paper about the relationship between safe client care and sources of ethical conflict in the healthcare setting. Which source of ethical conflict should the nursing student determine is the most significant to client​ safety? a Cost containment b Resource allocation c Specialists​' services d Staffing shortages

a,b,c,d (Ethical issues related to organ transplantation include allocation of​ organs; sale of body​ parts; consent to donate​ organs; and definition of death. Additional ethical issues related to organ transplantation include conflicts of interest between potential donors and​ recipients, and involvement of children both as potential donors and recipients. Donation by a family member is not considered an ethical issue.)

The nursing student is writing a report about ethical issues related to organ transplantation. Which items should be​ included? ​(Select all that​ apply.) a Involvement of children as recipients b Involvement of children as donors c Allocation to recipients d Definition of death e Family member donation

a, b, c, e The client with CP is at risk for multiple comorbidities to include​ depression, decreased cognitive​ ability, urinary and bowel​ incontinence, and premature aging. The client with CP is at risk for developing​ hypertension, not hypotension.

The parents of a child with cerebral palsy​ (CP) are concerned about possible future health problems. The nurse knows the client is at risk for which​ complication? (Select all that​ apply.) A. Depression B. Premature aging C. Decreased cognitive ability D. Hypotension E. Urinary incontinence

a, b, c, d Medications that are used to control seizures and spasms include skeletal muscle​ relaxants, baclofen,​ benzodiazepines, and botulinum toxin. Antidepressants are not used to manage the symptoms of CP.

The parents of a child with cerebral palsy​ (CP) ask if there are any medications available to help control the​ child's symptoms. Which type of medication should the nurse discuss with the​ parents? (Select all that​ apply.) A. Baclofen B. Muscle relaxants C. Benzodiazepines D. Botulinum toxin E. Antidepressants

d (Rationale: Autonomy is the client's (or surrogate's) right to make his or her own decision. The nurse is obliged to respect a parent's or significant other's informed decision regarding the client. This situation is not one of nonmaleficence (do no harm) or beneficence (do good). Justice (fairness) generally applies when the rights of one client are being balanced against those of another client. )

The parents of a child with no apparent brain function refuse to permit withdrawal of life support. Which moral principle is applied with the nurse's action to support the family's decision? a Nonmaleficence b Beneficence c Justice d Respect for autonomy

a (Rationale An advocate defends the cause of another​ person, so the nurse supporting the​ client's decision to end treatment was an advocate. The nurse who proposed an opinion that family reconciliation was a value was not supportive of the client. Advocacy is not limited by the amount of time left in life. An advocate does not propose choices that the client could have​ made, in the face of choices actually made.)

Two dialysis clinic nurses are discussing the recent death of a client with end stage renal disease. One nurse believed that the client​'s decision to end treatment was OK. The other nurse thought that the client should have extended life long enough to talk to an estranged child. Which nurse is exhibiting client​ advocacy? a The nurse who believed that the client​'s decision to end treatment is OK. b The nurse who thought that the client should have had a chance to reconcile with a child c Both nurses are​ advocates; they are proposing choices that the client could have made d Neither nurse is an​ advocate; the client had no real choice and would have died soon anyway

d An advocate defends the cause of another​ individual, so the nurse supporting the​ client's decision to end treatment is an advocate. The nurse who gave the opinion that family reconciliation was a priority was not supportive of the client. Advocacy is not limited by the amount of time left in life. An advocate does not propose choices that the client could have made in the face of choices actually made.

Two dialysis clinic nurses are discussing the recent death of a client with​ end-stage renal disease. One nurse believes that the​ client's decision to end treatment was correct. The other nurse thinks that the client should have continued treatment long enough to allow the client to talk to an estranged child. Which nurse is exhibiting client​ advocacy? A. Neither nurse is an​ advocate; the client had no real choice and would have died soon anyway. B. Both nurses are​ advocates; they are proposing choices that the client could have made. C. The nurse who thought that the client should have had a chance to reconcile with a child is exhibiting advocacy. D. The nurse who believes that the​ client's decision to end treatment was correct is exhibiting advocacy.

a,c,d,e (Rationale The components of ethics include​ rights, obligations, benefits to​ society, and fairness. Efficiency is not a component of ethics.)

Two hospice nurses are discussing the ethical implications of not admitting a client with a diagnosis of terminal cancer with a specific estimated number of months to​ live, which exceeds their facility​'s guidelines. Which components of ethics are appropriate for these nurses to consider regarding this​ situation? ​ (Select all that​ apply.) a Fairness to this client and other clients b Efficiency of the hospice functioning c Benefits to society of having hospice guidelines d Obligations of the hospice facility e Rights of this cancer patient

b (Morality refers to​ private, personal standards of right and​ wrong; ethics covers a broader range of standards. Both moral and ethical situations are described with words like "ought " and "should. ")

What is a difference between morality and​ ethics? a Ethical situations are described with words like "ought " and "​should; "moral situations don​'t use those words. b Morality refers to​ private, personal standards of right and​ wrong; ethics covers a broader range of standards. c Ethics refers to​ private, personal standards of right and​ wrong; morality covers a broader range of standards. d Moral situations are described with words like "ought " and "​should; " ethical situations don​'t use those words.

a (Rationale: A nurse's actions in an ethical dilemma must be defensible according to moral and ethical standards. The nurse may have strong personal beliefs, but distancing oneself from the situation does not serve the client. A team is not always required to reach decisions, and the nurse is not obligated to follow the client's wishes automatically when they may have negative consequences for self or others. )

Which action is the most important nursing responsibility when an ethical issue arises? a Being able to defend the morality of one's own actions b Ensuring that a team is responsible for deciding ethical questions c Remaining neutral and detached when making ethical decisions d Following the client and family wishes exactly

a (It would be inappropriate to counsel the client about risks of addictive behavior. The nurse should ask for support from a supervisor or​ peers, and plan on further assessment.)

Which action would be an inappropriate nursing response to a client with a history of​ long-term narcotic​ use, who is asking for increased pain medication after​ surgery? a Counsel client about risks of addictive behavior b Ask for support from a supervisor c Ask for support from peers d Plan on further assessment

a,b,d (Laws are enacted to reflect the ethical values of society. A specific situation can be​ moral, but perhaps not​ legal, and vice versa. A legal​ action, not an ethical​ action, gives some input into determining the​ morality, not the​ legality, of a situation. Following the law is making a choice to take a​ legal, not an​ ethical, action.)

Which are true statements about the relationship of ethics and laws. ​(Select all that​ apply.) a Laws are enacted to reflect the ethical values of society. b A specific situation can be​ moral, but perhaps not legal. c An ethical action gives some input into determining the legality of a situation. d A specific situation can be​ legal, but perhaps not moral. e Following the law is making a choice to take an ethical action.

a, b, c, d Echolalia​ (parroting a particular word or​ phrase), repetition of inquiries rather than responding to​ them, using you to represent ​I, and fascination with things that are lyrical in nature such as a song or verse are typical speech pattern abnormalities for children diagnosed with ASD. Stuttering is not a clinical manifestation associated with ASD

Which assessment finding should the nurse expect in a child with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Reiteration of questions as opposed to answering them B. Echolalia C. Enchantment with rhythmic repetition of verse or song D. Use of the word you to represent I E. Stuttering

a, b, d, e Clients with ASD have behaviors that interfere with functioning and can be harmful to​ them, such as banging their head or hitting solid objects. Provide clients who have ASD with early physical and occupational therapy that may be beneficial in developing some play and social skills. Clients with ASD may keep themselves in​ isolation, and assisting the clients to be able to be in the presence of others is a focus of treatment. The client with autism spectrum disorder may not progress to living​ independently; therefore, parents need to learn​ problem-solving skills to assist them and the client throughout life. Stimulants are a​ pharmacologic, not​ nonpharmacologic, treatment for autism spectrum disorder.

Which instruction should the nurse include when teaching the parents of a​ 3-year-old child with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Establishing therapies to assist with building play skills B. Providing methods to decrease the incidence of head banging C. Administering stimulants to calm repetitive motions D. Teaching problem solving regarding client issues E. Providing for play with other children of the same age

a, c, d, e Children with ASD will benefit from the following nonpharmacologic treatment​ options: establishing support for the parents and​ family; creating an environment that is conducive to positive behavior​ management; promoting enhanced​ communication; and educating the family about studies on the use of complementary care. Discouraging parents from vaccinating their children is not an appropriate treatment option for children with ASD.

Which intervention is an appropriate nonpharmacologic treatment for the nurse to include in the plan of care for a client with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Establishing support for the parents and family B. Encouraging parents not to vaccinate their children C. Teaching the family about studies on complementary care D. Promoting enhanced communication E. Creating an environment that is conducive to positive behavior management

c Clients with ASD need structure and a predictable course of action. Bringing in familiar objects from home provides comfort for the client. It is important for the nurse to be oriented to the room and care should be taken not to relocate objects in the environment. Clients with ASD are sensitive to loud noises and bright​ lights, so the television should be turned off to minimize stimuli that may distress the client. Procedures should be scheduled for the same time to maintain predictability.

Which intervention is most appropriate for the nurse to include in the plan of care for a child with autism spectrum disorder​ (ASD)? A. Putting the television on loud to provide stimulation for the client B. Rearranging the hospital room until a comfortable arrangement is found C. Encouraging the​ client's family to bring in familiar objects from home D. Scheduling procedures for different times each day

d Utensils with adaptive handles may improve​ self-feeding ability in children with spasticity associated with CP. Other possible interventions include feeding small amounts of food at a time. Restricting fluids and a​ low-fiber diet will not improve​ self-feeding ability in this client.

Which intervention should improve​ self-feeding ability in a child with spasticity caused by cerebral palsy​ (CP)? A. Providing a​ low-fiber diet B. Restricting hydration C. Presenting large portions of food all at one time D. Providing utensils with adaptive handles

c, d, e While there is no medication to cure​ ASD, medications are prescribed to manage behaviors and symptoms. These medications include​ stimulants, SSRIs, and mood stabilizers. ACE inhibitors and beta blockers are used to treat hypertension.

Which medication should the nurse expect to find on the medication administration record​ (MAR) for a child with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Beta blocker B. ​Angiotensin-converting enzyme​ (ACE) inhibitor C. Mood stabilizer D. Stimulant E. Selective serotonin reuptake inhibitor​ (SSRI)

1, 2. 1. Cerebral palsy is the most common chronic disorder of childhood. 2. There is an increased risk of cerebral palsy in infants with hyperbilirubinemia.

Which of the following applies to cerebral palsy? Select all that apply. 1. It is the most common chronic disorder of childhood. 2. Hyperbilirubinemia increases the risk of cerebral palsy. 3. It is a progressive chronic disorder. 4. Most children do not experience any learning disabilities. 5. There is a familial tendency seen in children with cerebral palsy.

a,d,e (Value clarifying questions or statements include o "Do you have a ​choice? "Are you considering other courses of ​action? " and "Tell me how you plan to start doing ​this? " Saying "What does your husband think you should ​do? " or "Do you want to know what I would ​do? " does not help clarify the​ client's values.)

Which questions or statements will help clients clarify their​ values? ​ (Select all that​ apply.) a "Are you considering other courses of ​action? " b "Do you want to know what I would ​do? " c "What does your husband think you should ​do? " d "Do you have a ​choice? " e "Tell me how you plan to start doing ​this? "

c,d,e (The relationships that are guided by the Code of Ethics from the International Council of Nurses are that of nurses and​ people, practice and​ co-workers. Their Code of Ethics does not concern relationships of nurses and payment or laws.)

Which relationships are guided by the Code of Ethics from the International Council of​ Nurses? ​(Select all that​ apply.) a Nurses and payment b Nurses and laws c Nurses and people d Nurses and​ co-workers e Nurses and practice

b Criteria for diagnosis can be found in the American Psychiatric​ Association's Diagnostic and Statistical Manual of Mental Disorders​, 5th edition​ (DSM-5), which includes screening tests to identify tendencies consistent with ASD. Although the other resources may be helpful in teaching the client and the family about​ ASD, they are not used as a diagnostic tool.

Which resource should the nurse expect the healthcare provider to use to confirm the diagnosis of autism spectrum disorder​ (ASD)? A. The Mental Health Rights Manual B. Diagnostic and Statistical Manual of Mental Disorders C. The Autism Handbook D. Teaching Social Communication to Families with Autism

b

a nurse is caring for a male client hospitalized with major depression and suicidal ideation. the client has improved over the course of 2 weeks, but the nurse has just learned that the clients spouse was seriously injured in a motor vehicle collision. the clients daughter has asked that he not be informed about his wifes presence in ICU. the nurse would like to make the ethical response to this request. after gathering information and identifying the ethical issues involved, what should the nurse do next? a. consider all courses of action b. define a personal and professional moral position c. collaborate with the healthcare provider to negotiate a solution d. determine the clients moral position on similar issues

b (Rationale: The nurse has an ethical responsibility to act only when actions are safe or risks minimized. This nurse is putting the client at unnecessary risk for a medication error. Many medical practices are controversial but not necessarily unethical; the nurse should follow the agency policy. Although some may view nurses' strikes as unethical, supporting others who are striking is a personal decision. A client's statement to a nurse may have ethical overtones, but it does not automatically constitute an ethical dilemma. Since the assigned primary care provider is a member of the team, principles of confidentiality do not include him or her. )

Which situation is a violation of the underlying principles associated with professional nursing ethics? a The nurses on the unit agree to sponsor a fund-raising event to support a labor strike proposed by fellow nurses at another facility. b A nurse colleague states, "I never look up medication indications. I just give what is prescribed." c The hospital policy permits use of internal fetal monitoring during labor even though there is literature that both supports and refutes the value of this practice. d A client reports that he didn't tell the doctor the truth when asked if he was following his therapeutic diet at home.

1. This situation involves differences of opinion among persons who have a legal responsibility to make decisions for the child. Consultation by the multidisciplinary members of the ethics committee may help caregivers reach an agreement.

Which situation would be appropriate to refer to the hospital ethics committee? 1. The physician recommends that a young child in the end stages of terminal cancer be taken off the ventilator. The parents, who are divorced and have joint custody of the child, have different views about whether to discontinue the ventilator. 2. A child in end-stage renal failure is placed on the renal transplant list. The parents are asked to sign permission for surgery after a cadaver kidney is located. One parent is out of town and gives telephone consent. 3. After initial therapies have failed, a child with leukemia is evaluated for a new cancer protocol. The child, age 8 years, gives assent for the new treatment, and his parents give consent as well. 4. Parents are shocked when their child is diagnosed with a malignant bone tumor. The orthopedic surgeon discusses the options of limb amputation and a limb- salvage procedure. The parents are asked to consider each option.

b (Beneficence concerns actions to promote good. Autonomy is the right to​ self-determination. Justice upholds fair treatment. Veracity means telling the truth.)

Which statement is a definition of​ beneficence? a Right to​ self-determination b Actions to promote good c Upholding fair treatment d Telling the truth

d Clients who are diagnosed with ASD thrive when routines are established and followed. The family should consider seeking a healthcare provider who has experience in treating a child with ASD. Therapies must be practiced and implemented in the home environment in order to be effective. The family would focus on the​ child's strengths, not the​ child's limitations.

Which teaching point is important for the nurse to include in the plan of care for a client who is diagnosed with autism spectrum disorder​ (ASD)? A. Maintaining the home as a​ treatment-free zone B. Focusing on limitations in order to see progress in care C. Keeping the same pediatric healthcare provider for all children in the family D. Establishing a routine

c

a nurse is assessing a 2 year old child. the mother tells the nurse that she is concerned because her child does not respond when called by name and does not seem to enjoy being held or cuddled. which of the following questions should the nurse prioritize when compiling the health history? a. does your child use the potty? b. does your child watch television? c. how many words does your child use? d. does your child have tantrums?

a, b, c

a nurse is assessing a 3 year old child for manifestations of autism spectrum disorder. which of the following manifestations reported by the childs parent are indications of autism? select all that apply a. nonverbal behavior b. repetitive counting c. fixation with objects d. somatic problems e. wide range of interest

c

a nurse is assessing a child who has autism. which of the following findings should the nurse expect? a. preoccupation of thoughts b. associative looseness c. echolalia d. magical thinking

b

a nurse is assessing a client who is postoperative following a radical mastectomy. the client reports a pain level of 8 out of 10. the nurses states that she will return soon with prescribed pain medication and follows through with this act. which of the following ethical principles is the nurse demonstrating? a. justice b. fidelity c. autonomy d. nonmaleficence

c

a nurse is caring for a client who continually makes sexually suggestive comments to the nurse and other staff. how should the nurse handle this situation? a. ignore the client whose behavior will stop of it does not elicit a reaction from you b. report the clients behavior to the clients HCP c. tell the client that the behavior is inappropriate and will not be tolerated d. avoid going into the clients room unless it is an emergency situation

d

a nurse is caring for a client who is the neighbor of a nurse on another unit. the nurse form the other unit asks the nurse about the clients medical diagnosis. the nurse displays which of the following ethical principles by not divulging the information? a. utility b. paternalism c. justice d. confidentiality

d

a nurse is caring for a client who refuses treatment and wishes to leave the facility. the provider asks the nurse to restrain the client. the nurse realizes that restraining this client is best identified with which of the following torts? a. defamation of character b. assault c. battery d. false imprisonment

d

a nurse is conducting assessments at a pediatric clinic. the nurse should identify that which of the following clients is at risk for child maltreatment? a. a school aged child b. a postmature infant c. an adolescent who is an only child d. a toddler who has autism