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A client arrives in active labor and exhibits toxemia with irregular fetal heart tones. The client is an immigrant and is uninsured. Which act would prevent the client from being transferred to another facility?
- A. Emergency Medical Treatment and Active Labor Law
- B. Health Insurance Portability and Accountability Act
- C. Patient Self-Determination Act
- D. The Patient Safety and Quality Improvement Act
Correct Answer: A
Rationale: The correct answer is A: Emergency Medical Treatment and Active Labor Law (EMTALA). This act prohibits hospitals from transferring patients in active labor or with an emergency condition based on insurance status or ability to pay. It ensures that all individuals, regardless of insurance or immigration status, receive necessary emergency medical treatment. The other choices are incorrect because:
B: Health Insurance Portability and Accountability Act (HIPAA) protects patient privacy and does not address transfer of patients in active labor.
C: Patient Self-Determination Act focuses on patient autonomy in making healthcare decisions, not on preventing transfer based on insurance status.
D: The Patient Safety and Quality Improvement Act promotes patient safety and quality improvement but does not specifically address transfer of patients in active labor.
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The Health Care Reform Act provides insurance for all U.S. citizens and legal residents presenting far-reaching ethical considerations related to diverse individual patient health care beliefs for those delivering nursing care. Nurses must consider their civil rights under the rights of conscience and how new health care agendas such as the Patient Protection and Affordable Care Act (PPACA) could affect their practice in situations that may conflict with their own belief system. Today's practicing nurse must:
- A. remember it is one's professional duty to render patient-centered care"even when it is in direct conflict with the nurse's own beliefs"or be held liable for withholding treatment.
- B. consider whether the right to act according to one's inner beliefs will continue to be permissible when federal health insurance becomes fully enacted.
- C. discuss with the patient and family different options in hopes they will accept the nurse's health care beliefs.
- D. suggest to the hospital administration that they not accept federal funding to prevent controversial health practices.
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct:
1. Professional duty: Nurses have a duty to provide patient-centered care regardless of personal beliefs.
2. Legal liability: Withholding treatment based on personal beliefs can lead to legal consequences.
3. Ethical considerations: Nurses must prioritize patient care over personal beliefs.
4. Rights of conscience: Nurses may have the right to refuse to participate in certain treatments, but they must still ensure patient care.
5. Patient-centered care: Nurses must respect patient autonomy and provide care based on the patient's wishes.
Summary of why the other choices are incorrect:
B. Irrelevant to the nurse's duty to provide patient-centered care.
C. Nurses should not impose their beliefs on patients but should respect and support their choices.
D. Suggesting the hospital not accept federal funding does not address the nurse's duty to provide patient-centered care.
A nurse practices a relaxing massage technique to stimulate and apply pressure to the feet or hands, increasing blood supply circulation to various parts of the body and relieving pain. The massage technique used by the practitioner is referred to as:
- A. reflexology.
- B. Feldenkrais method.
- C. Reiki.
- D. Rolfing.
Correct Answer: A
Rationale: The correct answer is A: reflexology. Reflexology is a practice based on the theory that specific areas on the feet and hands correspond to different organs and systems in the body. By stimulating these areas through massage techniques, blood circulation is increased, promoting healing and pain relief.
- Choice B, Feldenkrais method, focuses on improving movement and function through awareness and gentle movements, not specifically targeting reflex points.
- Choice C, Reiki, involves the transfer of energy to promote healing, but does not involve massage techniques or specific reflex points.
- Choice D, Rolfing, is a type of bodywork that focuses on manipulating the body's connective tissues to improve posture and alignment, not specifically targeting reflex points like in reflexology.
A current trend is for students to be evaluated to determine whether they demonstrate competence in the actual client care environment or with a standardized patient. This process occurs in addition to or instead of traditional pencil-and-paper evaluations. This type of evaluation is referred to as:
- A. core practice competencies.
- B. continuing competence.
- C. distance learning.
- D. performance-based assessment.
Correct Answer: D
Rationale: The correct answer is D: performance-based assessment. This type of evaluation focuses on assessing students' ability to perform tasks and demonstrate competence in real-world scenarios, such as client care environments or with standardized patients. It is a more practical and hands-on approach compared to traditional pencil-and-paper evaluations. Core practice competencies (A) refer to essential skills and knowledge required for a specific profession. Continuing competence (B) involves ongoing professional development to maintain skills and knowledge. Distance learning (C) is a method of education that does not require physical presence in a traditional classroom setting. Performance-based assessment best aligns with the description provided in the question, making it the correct choice.
When participating in a nurse licensure compact, the nurse:
- A. is held responsible for complying with the nursing practice laws in the state where practicing at the time care is rendered.
- B. must purchase a license in each state but does not retake the licensure examination.
- C. determines residency based on the state where educated as registered nurse.
- D. may practice using one license in any state or territory in the United States that recognizes the NCLEX as the source of licensure.
Correct Answer: D
Rationale: The correct answer is D because the Nurse Licensure Compact (NLC) allows nurses to practice using one license in any state that is part of the compact and recognizes the NCLEX as the source of licensure. This promotes mobility and access to care across state lines. Choice A is incorrect because the nurse is not held responsible for complying with the nursing practice laws of each state individually. Choice B is incorrect as purchasing a license in each state defeats the purpose of the compact. Choice C is incorrect as residency is not determined by where the nurse was educated but by the state where they hold a license.
A nurse develops a new nursing theory related to stress and viability. The nurse determines the theory accounts for historical events in which soldiers suffering from the stress of inadequate clothing to protect them from the cold and lack of correspondence from home had an increased mortality related to gunshot wounds. The theory will predict gunshot victims' need for proper clothing and letters from significant others as they serve in Iraq. Which criterion for theory acceptance is being validated?
- A. Inclusiveness
- B. Consistency
- C. Accuracy
- D. Simplicity
Correct Answer: C
Rationale: The correct answer is C: Accuracy. The nurse's theory is being validated based on its ability to accurately predict the need for proper clothing and letters from significant others for soldiers serving in Iraq. This criterion is essential for theory acceptance as it demonstrates the theory's ability to make accurate predictions based on historical events.
Inclusiveness (A) refers to the theory's ability to encompass a wide range of phenomena, which is not explicitly demonstrated in this scenario. Consistency (B) refers to the theory's internal coherence and agreement with existing knowledge, which is not the focus of the nurse's validation process in this case. Simplicity (D) refers to the theory's clarity and parsimony, which is not the primary criterion being validated here.
In summary, accuracy is the most relevant criterion being validated in this scenario as the nurse's theory is being assessed based on its predictive accuracy in relation to the soldiers' needs in Iraq.