Nokea
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.
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The nurse is preparing to discharge clients from the nursing unit. Which client has the greatest need to be referred for outpatient community services?
- A. A client newly diagnosed with skin cancer that lives with family.
- B. A client recovering from a stroke and is discharged to inpatient rehab.
- C. A client who is homeless and has a substance use disorder.
- D. A client leaving against medical advice for the treatment of cellulitis.
Correct Answer: C
Rationale: A homeless client with substance use disorder (C) has the greatest need for outpatient services to address social determinants and prevent relapse. Skin cancer with family (A), stroke rehab (B), and AMA cellulitis (D) have alternative support or less urgent needs.
The nurse cares for an unconscious client with a dissecting aortic aneurysm that needs urgent surgery. The client's family cannot be tracked. The nurse's priority action is:
- A. Send the client to surgery.
- B. Call the hospital lawyer.
- C. Search for all the client's contacts who can provide informed consent.
- D. Notify the nursing supervisor on-call and request their permission to waive informed consent.
Correct Answer: A
Rationale: For a life-threatening dissecting aortic aneurysm requiring urgent surgery, sending the client to surgery (A) is the priority under implied consent, as delay could be fatal. Contacting a lawyer (B), searching for contacts (C), or notifying the supervisor (D) delays critical intervention.
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 risk manager reviews an incident report completed by a nurse regarding a client’s fall. Which finding in the report demonstrates inappropriate documentation?
- A. The client’s explanation of the event.
- B. Subjective factors preceding the fall.
- C. Any injuries sustained as a result of the fall.
- D. The names of all witnesses present.
Correct Answer: B
Rationale: Subjective factors (B) are inappropriate in incident reports, as they may include opinions rather than objective facts. The client’s explanation (A), injuries (C), and witness names (D) are factual and appropriate to document.