Nokea
A 52-year-old woman is preparing to have her father move into her home after his discharge from the hospital. Which of the following subjects should the discharge planning nurse prioritize when preparing the woman for her new caregiving role?
- A. The availability and scope of community resources
- B. The importance of her own self-care and techniques for maximizing it
- C. Assertiveness training to ensure she can set limits
- D. Management of finances
Correct Answer: B
Rationale: The correct answer is B. It is crucial for the discharge planning nurse to prioritize the importance of the woman's self-care and provide techniques for maximizing it. When taking on a caregiving role, the caregiver's well-being is essential to ensure effective care for the patient. While community resources (choice A) are important, the immediate focus should be on self-care. Assertiveness training (choice C) and financial management (choice D) are also significant but not as critical as self-care for the caregiver in this scenario.
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Nurse B arrives for his regular night shift at a care facility for the aged. Due to a family emergency, he has only slept for 3 hours since his last shift. One of Nurse B's aides calls in sick, and there is no one available to replace the aide that night. With no help accessible, Nurse B lifts an obese patient from a wheelchair into a bed alone. Short on time and assistance, Nurse B decides to forgo the patient's evening bath. Legally, what does Nurse B most likely face?
- A. Little risk of liability because he is doing his best under difficult circumstances
- B. Immediate termination for dereliction of duty
- C. Liability if a pattern of negligence is identified in his performance evaluation
- D. A high risk of liability for his actions
Correct Answer: D
Rationale: In this scenario, Nurse B faces a high risk of liability for his actions due to several factors. Working with insufficient resources, failing to adhere to policies and procedures, taking shortcuts, and working while highly stressed are all situations that increase the risk of liability. Nurse B's decision to lift an obese patient without assistance and skip the patient's evening bath due to time constraints and lack of help are clear examples of actions that can lead to legal consequences. Choices A, B, and C are incorrect because the circumstances described in the scenario indicate a higher likelihood of liability due to the factors mentioned above.
A nurse is working in an assisted living facility that has a culturally diverse older adult population. Which statement by the nurse best demonstrates cultural sensitivity?
- A. We need to ensure that both the minority population and the majority population have their health needs met.
- B. It's important to remember that minority groups do not usually express their pain explicitly.
- C. We need to build our knowledge of clients who belong to cultural and ethnic groups that we're not familiar with.
- D. We need to teach all clients that their health problems are not necessarily the result of punishment.
Correct Answer: C
Rationale: The best demonstration of cultural sensitivity by the nurse is reflected in choice C. Building a knowledge base around cultural and ethnic groups is a crucial component of providing culturally sensitive care. Choice A creates an inaccurate dichotomy between 'minority' and 'majority' populations, which is not a culturally sensitive approach. Choice B incorrectly generalizes that minority groups do not usually express their pain explicitly, which is not true for all cultural groups. Choice D suggests imposing a different belief system on clients, which is not culturally sensitive and can undermine trust and rapport with older adult clients.
To receive government funding, a county hospital must provide demographic statistics on its client population. When selecting the box labeled Hispanic on the forms, what characteristic of the client population would a worker consider?
- A. immigrant workers who entered the United States and their descendants
- B. immigrants who have a Spanish accent
- C. native Spanish-speaking people living in the United States
- D. persons with brown skin and dark hair
Correct Answer: C
Rationale: The correct answer is C because the term 'Hispanic' includes Spanish-speaking individuals from various countries like Spain, Cuba, Mexico, and Puerto Rico. It is essential to understand that Hispanic does not solely refer to individuals with brown skin, dark hair, or those with a Spanish accent. Therefore, choices A, B, and D do not accurately represent the characteristic of the client population that would be classified as Hispanic.
How does the doctrine of respondent superior affect nurses?
- A. Liable for injury resulting from advice given to a member of a patient's family
- B. Responsible for double-checking the doses of medication ordered by a physician
- C. Responsible for the actions of the staff they supervise
- D. Obligated to obtain informed consent for any diagnostic procedure
Correct Answer: C
Rationale: The correct answer is C. The doctrine of respondent superior holds that supervisors are accountable not only for their own actions but also for the actions of the staff they oversee. This means that nurses, as supervisors, are responsible for ensuring that the actions of their staff comply with established protocols and standards of care. Choices A, B, and D are incorrect because they do not directly relate to the principle of respondent superior. Nurses may have other responsibilities related to giving advice, medication administration, and obtaining consent, but the doctrine of respondent superior specifically pertains to the accountability of supervisors for the actions of their subordinates.
To minimize liability, what action should nurses take when accepting telephone orders from physicians?
- A. Ask the physician to follow up with a faxed, written order
- B. Clearly communicate the most likely diagnosis to the physician
- C. Have another staff member talk with the physician and audiotape the conversation
- D. Accept only written orders or those communicated orally, in person
Correct Answer: A
Rationale: The best action for nurses to take when accepting telephone orders from physicians to minimize liability is to ask the physician to follow up with a faxed, written order and ensure it is signed within 24 hours. This approach helps ensure clarity, accuracy, and documentation of the physician's orders, reducing the risk of misinterpretation or errors. Choices B, C, and D are incorrect. Communicating a diagnosis is outside the nurse's scope of practice and should be done by the physician. Involving another staff member to audiotape the conversation can introduce legal and practical issues. Accepting only written or orally communicated orders in person may not always be practical or feasible in urgent situations where telephone orders are necessary.