Nokea
The Hispanic client who has terminal cancer is requesting a curandero to come to the bedside. Which intervention should the nurse implement?
- A. Tell the client it is against policy to allow faith healers.
- B. Assist with planning the visit from the curandero.
- C. Refer the client to the pastoral care department.
- D. Determine the reason the client needs the curandero.
Correct Answer: B
Rationale: Facilitating a curandero visit respects Hispanic cultural beliefs, per patient-centered care. Denying, referring, or questioning the need is less culturally sensitive.
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The nurse is caring for a client who is confused and fell trying to get out of bed. There is no family at the client's bedside. Which action should the nurse implement first?
- A. Contact a family member to come and stay with the client.
- B. Administer a sedative medication to the client.
- C. Place the client in a chair with a sheet tied around him or her.
- D. Notify the health-care provider to obtain a restraint order.
Correct Answer: D
Rationale: Notifying the HCP for a restraint order ensures safety and legal compliance for a confused client at risk of falls. Family contact, sedation, or makeshift restraints are unsafe or secondary.
The family has requested a client with terminal cancer not be told of the diagnosis. The client tells the nurse, 'I think something is really wrong with me, but the doctor says everything is all right. Do you know if there is something wrong with me?' Which response by the nurse would support the ethical principle of veracity?
- A. I think you should talk to your doctor about your concerns.
- B. What makes you think something is really wrong?
- C. Your family has requested you not be told your diagnosis.
- D. The doctor would never tell you incorrect information.
Correct Answer: C
Rationale: Veracity (truth-telling) requires honesty; acknowledging the family’s request respects their wishes while addressing the client’s question, prompting further discussion. Other responses evade truth.
The nurse is teaching a class on ethical principles in nursing. Which statement supports the definition of beneficence?
- A. The duty to prevent or avoid doing harm.
- B. The duty to actively do good for clients.
- C. The duty to be faithful to commitments.
- D. The duty to tell the truth to the clients.
Correct Answer: B
Rationale: Beneficence is the duty to actively promote client well-being, per ethical principles. Nonmalfeasance, fidelity, and veracity are distinct principles.
In which client situation would the AD be consulted and used in decision making?
- A. The client diagnosed with Guillain-Barré who is on a ventilator.
- B. The client with a C6 spinal cord injury in the rehabilitation unit.
- C. The client in end-stage renal disease who is in a comatose state.
- D. The client diagnosed with cancer who has Down syndrome.
Correct Answer: C
Rationale: ADs are consulted when a client cannot make decisions, such as in a comatose state (end-stage renal disease). Ventilated, rehab, or Down syndrome clients may still have decision-making capacity.
The nurse and an unlicensed assistive personnel (UAP) are caring for a group of clients in a pain clinic. Which intervention would be inappropriate to delegate to the UAP?
- A. Assist the client diagnosed with intractable pain to the bathroom.
- B. Elevate the head of the bed for a client diagnosed with back pain.
- C. Perform passive range of motion for a client who is bedfast.
- D. Monitor the potassium levels on a client about to receive medication.
Correct Answer: D
Rationale: Monitoring potassium levels requires nursing judgment, outside UAP scope. Assisting to bathroom, elevating bed, and range of motion are within UAP capabilities.