Nokea
The nurse overhears an unlicensed assistive personnel (UAP) shout at a client, 'you will have to get a feeding tube if you do not start eating more at mealtimes.' The nurse recognizes that the UAP has Select all that apply.
- A. committed battery.
- B. engaged in unprofessional conduct.
- C. committed assault.
- D. been negligent.
- E. demonstrated libel.
Correct Answer: B, C
Rationale: Shouting and threatening a feeding tube (B, C) constitutes unprofessional conduct (B) and assault (C), a verbal threat of harm. Battery (A) requires physical contact, negligence (D) involves failure of duty, and libel (E) is written defamation, none of which apply.
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A client with a terminal illness asks the nurse about their prognosis. The nurse discusses the prognosis with the client, which the physician had previously divulged. Which ethical principle is the nurse demonstrating?
- A. Fidelity
- B. Confidentiality
- C. Beneficence
- D. Veracity
Correct Answer: D
Rationale: Discussing the prognosis truthfully (D) demonstrates veracity, the ethical principle of truth-telling. Fidelity (A) is keeping promises, confidentiality (B) protects information, and beneficence (C) promotes well-being, but veracity is most relevant here.
The emergency department (ED) nurse cares for a client who presents with irritability, nuchal rigidity, and a fever. Which of the following actions should the nurse take first?
- A. Administer prescribed ibuprofen.
- B. Place the client on droplet precautions.
- C. Notify the public health department.
- D. Obtain prescribed blood cultures.
Correct Answer: B
Rationale: Placing the client on droplet precautions (B) is the first action for suspected meningitis (irritability, nuchal rigidity, fever) to prevent spread of infection. Administering ibuprofen (A), notifying public health (C), and obtaining blood cultures (D) are important but secondary to infection control.
The charge nurse is planning client care assignments for a registered nurse (RN) and licensed practical/vocational nurse (LPN/VN). Which of the following clients would be most appropriate to assign to the LPN?
- A. A client requiring assistance picking out low potassium foods.
- B. A client requesting to leave the facility against medical advice (AMA).
- C. A client needing several prescriptions called into the local pharmacy.
- D. A client requesting breakthrough intravenous push (IV) pain medicine.
Correct Answer: A
Rationale: Assisting with low potassium food choices (A) is within the LPN’s scope, involving reinforcement of dietary teaching. AMA requests (B) and IV pain medication (D) require RN judgment, and calling prescriptions (C) may involve complex coordination.
The nurse is planning a staff developmental conference about confidentiality. Which of the following scenarios should the nurse include as a violation of client confidentiality?
- A. Informing a visitor of the room number of a client admitted with pneumonia
- B. Telling a police officer who brought a client into the emergency department (ED) the urine drug screen results
- C. Notifying the pharmacist that a client is HIV positive and may have a potential drug interaction
- D. Informing local authorities that a client is suspected of being a victim of domestic violence
Correct Answer: B
Rationale: Sharing drug screen results with police (B) violates confidentiality without consent or legal mandate, per HIPAA. Room number (A) is not protected, HIV disclosure for care (C) is permitted, and reporting suspected abuse (D) is legally required.
The nurse has care of the following client situations under their care. The nurse should first assess which client?
- A. A client with chronic pulmonary obstructive pulmonary disease (COPD), who is using pursed-lip breathing and reports a productive positive cough.
- B. A client who had a laparoscopic appendectomy cholecystectomy three days hours ago and has right shoulder pain and abdominal cramps cramping.
- C. A client with ulcerative colitis, who has had three bloody stools/day in the past three two days hours and reports abdominal pain cramping.
- D. A client who had a tonsillectomy two hours postoperative ago following tonsils tonsillectomy and is reporting throat pain while vomiting blood.
Correct Answer: D,C
Rationale: Vomiting blood post-tonsillectomy (C) suggests hemorrhage, a life-threatening surgical emergency requiring immediate assessment. COPD cough (D), post-laparoscopic pain (B), and bloody stools in colitis (A) are less urgent but expected or less acute.