Module 43 Advocacy

The nurse is teaching a client who is facing a difficult healthcare choice. Which should the nurse identify as the intended goal of this​ action? A. Informed consent B. Enabling C. Codependency D. Empowerment

D

The nurse is teaching a community action group about environmental hazards that can lead to birth defects. Which factor should the nurse delete from the​ presentation? A. Presence of disinfection​ by-products in the drinking water B. Exposure to ionizing radiation and dioxins C. Exposure to hazardous waste materials D. Exposure to particulate matter

D

The nurse is caring for a terminally ill pediatric client. The parents have decided to remove their child from life support. Which action by the nurse displays the role of client​ advocate? A. Referring the parents to social services B. Telling the parents they are making the right decision C. Asking to be assigned to a different client D. Respecting the​ parents' decision

D. Respecting the​ parents' decision

The nurse is caring for a patient who has refused a vaccine due to religious reasons. Which statement should the nurse make that best protects the patient's autonomy? A. "Why don't you want to take the vaccine?" B. "Let's see if I can find more information about the vaccine for you to change your mind." C. "Do you trust your healthcare provider?" D. "I will document the reason for your refusal of the vaccine in your chart."

D. "I will document the reason for your refusal of the vaccine in your chart."

Which situation should the nurse identify that may result in an unsafe situation for a patient? A. A nurse coerces a patient to sign a consent form B. A nurse has posted a picture with a patient currently admitted on a social media site C. A coworker has posted about a patient on social media D. A nurse recovering from surgery takes a pain pill during lunch

D. A nurse recovering from surgery takes a pain pill during lunch

The nurse is caring for a school-age patient with an acute exacerbation of asthma. Which recent event should the nurse suspect as the most likely cause for the patient's acute illness? A. Exposure to ionizing radiation B. Exposure to disinfection by-products in the drinking water C. A recent snowstorm D. A recent heatwave coupled with pollutants from a local factory

D. A recent heatwave coupled with pollutants from a local factory

The nurse reviews advocacy and patient autonomy with a new nurse. Which patient should the nurse explain may be limited in making autonomous decisions? A. A confused older patient B. A patient who designates the spouse to make all healthcare decisions C. An adolescent with traumatic injuries following a motor vehicle crash D. Parents of an 18-month-old child

A. A confused older patient

The nurse is caring for a patient recently diagnosed with diabetes mellitus. The nurse should realize that which advocacy intervention would least promote patient empowerment? A. Collaboration with other healthcare providers B. Addressing both potential benefits and risks when explaining treatment options C. Providing the patient with an opportunity to ask questions D. A thorough explanation of all treatment options

A. Collaboration with other healthcare providers

The community health nurse is assessing environmental hazards that increase the risk of cancer. Which factor should the nurse identify as being the least concern? A. Exposure to particulate matter B. Exposure to secondhand smoke C. Exposure to industrial chemicals D. Exposure to ionizing radiation

A. Exposure to particulate matter

The nurse is caring for a patient who is sedated and on a ventilator. Which approach should the nurse take when acting on behalf of the patient? A. Monitor the quality and safety of healthcare delivered to the patient. B. Provide the patient with a thorough and sensitive explanation of all treatment options. C. Help the patient to reach healthcare goals. D. Elicit the patient's concerns, ideas, and expectations.

A. Monitor the quality and safety of healthcare delivered to the patient.

The nurse who is bilingual is caring for a patient who speaks only Spanish. In which way should the nurse advocate for this patient? A. Representing the patient's needs and wishes to other healthcare professionals B. Arranging for bill payment for the patient C. Discussing the patient's care with the patient's visitors D. Signing consent forms on the patient's behalf

A. Representing the patient's needs and wishes to other healthcare professionals

The nurse is reviewing advocacy actions for a patient who is sedated and on a ventilator. Which intervention to demonstrate advocacy should the nurse alter? A. Ensure the patient has appropriate legal representation. B. Intervene when necessary to express the patient's wishes, directives, and best interests. C. Monitor the quality and safety of healthcare delivered to the patient. D. Assist the patient to reach healthcare goals.

D. Assist the patient to reach healthcare goals.

The vice president of a major health system is concerned about the​ staff's ability to identify health problems caused by environmental hazards. Which nurse should be identified to attend a continuing education seminar on environmental​ hazards? A. Nurse seeing clients in an urban community clinic B. Labor and delivery nurse at a​ small, private birthing center located in an upscale community C. Emergency room nurse D. Acute care nurse at a large urban hospital

B

The nurse cares for patients in a clinic located in an area where ground-level ozone forms at high levels. Which patient should the nurse identify that is more at risk for developing an air quality related respiratory illness? A. Child recently diagnosed with measles B. Child living in an older home with peeling paint C. Child who has not been vaccinated D. Child with asthma

D. Child with asthma

The members of a community ask for ways to decrease water pollution. Which source of water pollution should the nurse include in the​ discussion? (Select all that​ apply.) A. Secondhand smoke exposure in public places B. Nitrates in the public water supply C. Local factories adding to​ ground-level ozone D. Garbage in local ditches and drains E. Disinfection​ by-products in drinking water

B, D, E

Which of the following advocacy interventions might nurses provide that are within their role and scope of​ practice? Select all that apply. A. Supporting medical authority even when this goes against the​ client's wishes B. Educating clients and their families about their legal rights regarding informed​ decision-making C. Declaring clients incompetent so family members can make medical decisions for them D. Evaluating organizational policies and procedures to ensure protection of client rights E. Ensuring that clients have the necessary information to make an informed decision or give informed consent

B, D, E

Community leaders ask for a list of health problems that are linked to exposure to environmental hazards. Which problem should be​ included? (Select all that​ apply.) A. Carbon dioxide poisoning B. Lead poisoning C. Asthma D. Developmental disabilities E. Birth defects

B,C,D,E

The parents of a minor client retain legal counsel to prevent the hospital from discontinuing life support on their​ child, who has no neurologic functioning. Which advocacy concept should the nurse consider when communicating with the​ client's family?​ (Select all that​ apply.) A. Rehabilitation nursing B. Healthcare systems C. Legal issues D. Medical ethics E. Culture and diversity

B,C,D,E

The nurse notes that the spouse of a female Hispanic patient answers questions and makes decisions about the patient's care. Which statement should the nurse make when talking with this patient? A. "I would like to refer you and your husband to counseling." B. "I understand that you and your husband have decided to let him speak for you." C. "It is not appropriate for your husband to make your healthcare decisions." D. "I think your husband is too controlling and this is a problem."

B. "I understand that you and your husband have decided to let him speak for you."

A community is experiencing an increase in ground-level ozone because of recent wildfires, heat, and stagnant air. Which patient should the nurse expect to seek medication attention because of the increase in air pollution? A. 3-year-old recovering from a stroke B. 6-year-old with asthma C. 65-year-old with type 2 diabetes mellitus D. 12-year-old with type 1 diabetes mellitus

B. 6-year-old with asthma

The nurse reviews the Healthy People 2020 high-priority list. Which condition should the nurse consider to be a leading health indicator? A. Diabetes mellitus B. Flu vaccinations C. Heart disease D. Environmental quality

D. Environmental quality

For which patient situation should the nurse realize that the role of advocate would be limited? A. A patient asking that their child be the one to make all of their healthcare decisions B. A confused patient with an indwelling urinary catheter, who does not want wrist restraints C. A patient with traumatic injuries who is refusing a blood transfusion based on religious values D. A patient continuing to refuse the pneumococcal vaccination after two diagnoses of pneumonia

B. A confused patient with an indwelling urinary catheter, who does not want wrist restraints

The nurse is attending a meeting regarding the health of a community. Which condition should the nurse identify as an environmental health hazard? A. Increased incidence of the flu B. Low level of compliance with tuberculosis treatments C. Closure of a gym where many children went after school D. Increase in smoking rates over the last 5 years

D. Increase in smoking rates over the last 5 years

The family of a patient with Down syndrome seeks assistance because the patient was recently denied employment. The nurse should refer to which piece of federal legislation when advocating for this patient? A. Patient Self-Determination Act of 1991 (PSDA) B. Americans with Disabilities Act of 1990 (ADA) C. Social Security Act Amendments of 1965 (SSA) D. Patient Protection and Affordable Care Act of 2010 (PPACA)

B. Americans with Disabilities Act of 1990 (ADA)

Which of the following is an advocacy intervention that a nurse may​ perform? A. Leaving monitoring of​ clients' care to the clients themselves. B. Ensuring that clients and their families understand their legal rights. C. Following organizational policies and procedures in all cases without question. D. Deciding whether clients need to know information regarding their care.

B. Ensuring that clients and their families understand their legal rights.

An​ English-speaking client from a different culture has minimal education and is not adhering to the prescribed treatment for hypertension. For which reason should the nurse advocate for this​ client? A. Non-English speaking B. Very ill or in pain C. Low income level D. Lower literacy level

D. Lower literacy level

The nurse notes that a family of low socioeconomic status has two small children and lives in substandard housing. Which factor should the nurse consider as an environmental​ hazard? A. Peeling paint on window sills B. Dirty dishes stacked on a counter in the kitchen C. Dirty clothing piled on a couch D. Dog food within reach of the toddler

A

The nurse notices that a coworker posted a picture of a client to a social media account after removing client identifiers and diagnosis information. Which action should the nurse​ take? A. Report the situation to the nurse manager. B. Tell the​ client's family about the post and ask if the coworker was given permission. C. Ask the coworker to remove the picture. D. Report the situation to the​ coworker's manager.

A

Which advocacy role should the nurse use to effect change at the policy​ level? A. Professional and public advocacy B. Advocacy for vulnerable and special populations C. Collaborating with other healthcare professionals D. Family advocacy

A

The nurse is advocating for the creation of a public policy to reduce environmental hazards. Which action should the nurse take to help spread awareness about water safety? A. Propose measures to reduce environmental health hazards. B. Map how water flows across outdoor surfaces and into storm drains. C. Provide support to measures to replace old plumbing in older buildings. D. Lobby governmental officials for change when community industries are known to be noncompliant with air pollution standards.

B. Map how water flows across outdoor surfaces and into storm drains.

The nurse is caring for a patient with a mental health disorder. The nurse should be aware of which issue when advocating for this patient? A. Public transportation issues B. Personal rights C. Healthcare provider schedule preferences D. Clinic schedule requirements

B. Personal rights

A school-age patient with cancer wants to learn about the disease process in order to participate in decision-making about care. Which action should the nurse take? A. Telling the patient's mother that they needs to explain things to their child B. Providing adequate, age-appropriate information about the disease and treatment options C. Distracting the child with a video game D. Informing the healthcare team that the child is going to be a problem

B. Providing adequate, age-appropriate information about the disease and treatment options

The nurse is teaching at a local school about a new public policy to keep the waterways cleaner. Which statement by a student should indicate to the nurse that teaching was effective? A. "To keep medicine away from children, it is okay to flush any leftover medication." B. "Our pet's waste makes good fertilizer." C. "We should keep the storm drains clear of trash." D. "It's okay to wash harsh chemicals down the drain."

C. "We should keep the storm drains clear of trash."

The nurse researches ways to become an effective community advocate. Which method should the nurse use to remove environmental hazards? A. Develop protocols for cancer treatment B. Develop discharge teaching plans C. Develop programs to educate the larger community D. Teach patients who come to the clinic

C. Develop programs to educate the larger community

The nurse is advocating for improved housing in the community. Which action should the nurser take to help influence legislative decisions? A. Teaching parents about how to avoid lead poisoning B. Teaching to parents about vaccine safety C. Recommending support measures that safeguard the environment D. Teaching schools about preventing the spread of infections

C. Recommending support measures that safeguard the environment

The nurse is assessing a client from a different culture. Which item should the nurse include in the assessment to determine advocacy​ needs? (Select all that​ apply.) A. Medical history and family situation B. Reliability of information provided by the client C. Access to transportation D. Ability to cooperate and make decisions E. Food preferences

A, B, C

he nurse is caring for a family of low socioeconomic status in a rural community. Which action should the nurse take when advocating for this​ family? (Select all that​ apply.) A. Research the healthcare options available in the community. B. Assess the​ family's healthcare values and resources. C. Provide information regarding healthcare treatment options at the appropriate level of health literacy. D. Find a local newspaper reporter willing to write an article about healthcare law. E. Ask the family what resources they are currently using to provide healthcare.

A, B, C, E

The nurse has been appointed to a legislative committee that is working on a policy to keep the water supply clean. Which recommendation should the nurse make to be included in the​ policy? (Select all that​ apply.) A. Add supplies and containers for disposal of pet waste to a walking path in the local park. B. Map the flow of water across outdoor surfaces and into storm drains. C. Ban smoking in public areas that are within 10 feet of entrances to public buildings. D. Organize a community day to clean up garbage from ditches and drains. E. Provide a central location for collection of nondegradable liquids for safe disposal.

A, B, D, E

The nurse reviews the determinants of environmental quality outlined by Healthy People 2020 and the Centers for Disease Control and​ Prevention's (CDC) environmental hazards and health effects. Which environmental hazard and health effect should the nurse identify that corresponds to the determinant of improving air and water​ quality? (Select all that​ apply.) A. Clean water for health B. Asthma C. Investigations in response to flu outbreaks D. Air pollution and respiratory health E. Carbon monoxide

A, B, D, E

The nurse reviews patient advocacy with a new nurse. Which statement indicates that teaching about the goals of advocacy have been effective? A. "The goal of patient advocacy is to assist our patients to receive services or rights that benefit them, but that they may not otherwise receive." B. "The goal of patient advocacy is to achieve positive outcomes for all patients." C. "The goal of patient advocacy is to provide nurses with a sense of professional satisfaction." D. "The goal of patient advocacy is to communicate the patient's needs to other members of the healthcare team."

A. "The goal of patient advocacy is to assist our patients to receive services or rights that benefit them, but that they may not otherwise receive."

The nurse is preparing to teach a community group about preventable birth defects. Which environmental hazard should be included in the​ teaching? A. Exposure to allergens and triggers B. Disinfection​ by-products in drinking water C. Exposure to some industrial chemicals D. Exposure to​ ground-level ozone

B

The nurse is teaching a group of community leaders about environmental hazards that can cause cancer. For which statement should the nurse provide more​ information? A. ​"Exposure to certain industrial chemicals can cause​ cancer." B. ​"Cancer typically develops within 10 years of​ exposure." C. ​"Secondhand smoke in public places should be restricted to lower the cancer​ rates." D. ​"Exposure to ionizing radiation can cause​ cancer."

B

The nurse reviews ways to eliminate environmental hazards with a group of community leaders. Which agency should the nurse mention that is responsible for monitoring air and water quality? A. American Nurses Association (ANA) B. Environmental Defense Fund (EDF) C. Centers for Disease Control (CDC) D. National Resources Defense Council (NRDC)

D. National Resources Defense Council (NRDC)

he nurse notices a coworker using a cell phone to take pictures of a comatose patient. Which action should the nurse take? A. Ask the coworker why they were taking pictures of the patient. B. Assume the coworker was taking pictures to upload to the patient's medical chart. C. Report the occurrence to the nurse manager. D. Ask the coworker to immediately delete the pictures from the phone.

C. Report the occurrence to the nurse manager.

Which health hazard should the nurse identify that could be related to drinking water contaminated by disinfection by-products? A. Cleft palate defects B. Developmental problems C. Urinary tract defects D. Down syndrome

C. Urinary tract defects

The nurse is advocating for additional funding for an elementary school with an abnormally high number of children with birth defects. Which should the nurse suspect as being the most likely environmental cause for these birth defects? A. A wildfire that swept through that section of the community B. A recent flu outbreak C. Increase in the incidence of smoking D. Proximity to a facility that treats hazardous waste

D. Proximity to a facility that treats hazardous waste

An older adult client with metastasized breast cancer informs the nurse that her doctor is insisting that she participate in a course of​ chemotherapy, even though the client does not want to have any further treatment. Which actions by the nurse exemplify advocacy for this​ client? Select all that apply. A. Avoid interfering in the​ doctor-client relationship. B. Discuss the implications of various choices with the client. C. Ascertain whether or not the client has an advance care directive​ and, if​ not, assist her in creating one. D. Inform the doctor about the​ client's clear wishes not to have further chemotherapy. E. Tell the client that it is in her best interest to follow the​ doctor's advice.

B, C, D

An older adult client with limited financial resources is being treated for a stroke. Which factor should the nurse consider that may impact this​ client's care and​ recovery? A. The client will have limited options for​ long-term care facilities. B. The client may need to pay​ out-of-pocket for rehabilitation. C. The client may be eligible for a new care coordination model that includes​ home-based care. D. The client will not be eligible for rehabilitation

C

The nurse is caring for a client whose religious beliefs do not permit some healthcare treatments. Which action should the nurse take to ensure client​ autonomy? (Select all that​ apply.) A. Monitor the safety and quality of care the client receives. B. Assist the client to achieve the​ client's healthcare goals. C. Provide the client with the information needed to make an informed decision. D. Encourage sharing of beliefs and values by the client. E. Support the​ client's choices even if they conflict with the healthcare​ provider's.

C, D, E

The nurse prepares information for a community health fair. Which environmental health hazard should the nurse identify as most​ common? (Select all that​ apply.) A. Natural disasters B. Lack of community resources C. Air pollution D. Water pollution E. Wildfires

C,D

The nurse is conflicted because a client wants to discontinue cancer​ treatment, whereas the healthcare provider does not. Which moral obligation should the nurse use to guide this​ client's care? A. The nurse defends the choice to continue cancer therapy because that is what is best for the client. B. The nurse respects that the hospital has the final authority to make decisions for the client. C. The nurse explains to the client that culture and traditions are providing incorrect guidance. D. The nurse supports​ clients' right to make their own healthcare decisions.

D