Nokea
A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed:
- A. Defamation
- B. assault
- C. battery .
- D. fraud.
Correct Answer: C
Rationale: Battery occurs when there is an intentional touching of another person without their consent. In this case, the nurse began cardiopulintary resuscitation on a client who had requested a "Do Not Resuscitate" (DNR) order, which means the client did not consent to the resuscitation. This action can be considered as battery because the client's wishes were not respected, and the nurse proceeded with a medical intervention against those wishes, leading to harm and potential legal consequences. This is different from assault, which involves a threat of force, and from defamation and fraud, which are not applicable to this situation.
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If transient discoloration of Baby Sharon's skin is noted while under phototherapy, what is this phenomenon called?
- A. Cyanosis
- B. Hyperbilirubinemia
- C. Jaundice
- D. Bronze baby syndrome
Correct Answer: D
Rationale: Bronze baby syndrome is the term used to describe the transient discoloration of a baby's skin while undergoing phototherapy treatment for jaundice. This phenomenon typically occurs in preterm infants and is believed to be caused by the breakdown of bilirubin into colored pigments during phototherapy. The discoloration can range from a bronze or brownish color to a grayish-green hue. One key characteristic of bronze baby syndrome is that the discoloration is reversible once phototherapy is complete and does not indicate any underlying health concerns. It is important for healthcare providers to be aware of this phenomenon to avoid unnecessary interventions or alarm to the caregivers.
A patient presents with multiple, flesh-colored, papular lesions with a central dell on the face and trunk. The lesions have a tendency to bleed upon minor trauma and have been increasing in number over time. Which of the following conditions is most likely responsible for this presentation?
- A. Basal cell carcinoma
- B. Squamous cell carcinoma
- C. Seborrheic keratosis
- D. Actinic keratosis
Correct Answer: A
Rationale: The description of multiple flesh-colored papular lesions with a central dell that tend to bleed upon minor trauma and have been increasing in number over time is characteristic of basal cell carcinoma. Basal cell carcinoma is the most common type of skin cancer and typically presents as pearly or flesh-colored papules with telangiectasias (tiny blood vessels) and a characteristic central dell or ulceration. This type of skin cancer often occurs on sun-exposed areas like the face and trunk and can manifest as slow-growing lesions that may bleed easily with minor trauma. In contrast, squamous cell carcinoma typically presents as a scaly or crusted lesion, seborrheic keratosis is a benign skin growth with a waxy, stuck-on appearance, and actinic keratosis is a precancerous lesion characterized by rough, scaly patches on sun-exposed areas.
A patient with a history of rheumatoid arthritis presents with acute pain and swelling of the wrist joint. Physical examination reveals ulnar deviation of the fingers and swan-neck deformity of the digits. Which imaging modality is most appropriate for further evaluation of wrist involvement in rheumatoid arthritis?
- A. X-ray
- B. Magnetic resonance imaging (MRI)
- C. Ultrasound
- D. Dual-energy X-ray absorptiometry (DEXA) scan
Correct Answer: A
Rationale: X-ray is the most appropriate imaging modality for evaluating wrist involvement in rheumatoid arthritis. It can show joint space narrowing, erosions, soft tissue swelling, and periarticular osteopenia. X-rays are readily available, cost-effective, and provide valuable information about joint damage and disease progression in rheumatoid arthritis. In this case, X-ray would be able to confirm the presence of erosions, joint deformities, and assess the severity of the disease in the wrist joint. While MRI and ultrasound can also be helpful in evaluating rheumatoid arthritis, X-ray remains the initial imaging modality of choice due to its convenience and ability to assess bony changes. Dual-energy X-ray absorptiometry (DEXA) scan is not indicated for evaluating wrist involvement in rheumatoid arthritis.
Which of the following actions is a violation of a psychiatric patient's rights?
- A. Paranoid patient with delusions about his family is told that if he makes a will, it might not be valid.
- B. The nurse confiscated the cellphone from patient's room and tell him it is being locked in the vault.
- C. Staff members confiscated written letters done by patients addressed to local newspaper.
- D. Patient is paid minimum wage for helping in the hospital kitchen.
Correct Answer: C
Rationale: In this scenario, the action that violates a psychiatric patient's rights is option C, where staff members confiscated written letters done by patients addressed to the local newspaper. Patients have the right to communicate freely and express their thoughts and feelings through various means, such as letter-writing. Confiscating these letters is a violation of their rights to free expression and communication. It is essential to respect and uphold the rights of psychiatric patients, including their right to communicate with others.
A profession is characterized by the following except:
- A. Body of knowledge
- B. Code of ethics
- C. member of professional organization
- D. Engages in research
Correct Answer: C
Rationale: A profession is characterized by having a body of knowledge, a code of ethics, and engaging in research. However, being a member of a professional organization is not a defining characteristic of a profession. While many professionals may choose to join professional organizations for networking, support, and career advancement reasons, membership in such organizations is not universally required or exclusive to being considered a professional in a particular field. Hence, the presence or absence of professional organization membership does not determine the professional status of an individual.