Nokea
A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?
- A. Amitriptyline decreases the depression caused by your foot pain.
- B. Amitriptyline helps prevent transmission of pain impulses to the brain.
- C. Amitriptyline corrects some of the blood vessel changes that cause pain.
- D. Amitriptyline improves sleep and reduces awareness of nighttime pain.
Correct Answer: B
Rationale: The correct answer is B because amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, thus helping to prevent the transmission of pain impulses to the brain. This mechanism of action is effective in managing neuropathic pain, such as burning foot pain in diabetic patients. Choices A, C, and D are incorrect because amitriptyline's primary mechanism of action is related to its effects on neurotransmitter reuptake, not directly related to mood improvement, blood vessel changes, or sleep improvement.
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A client discharges AMA (against medical advice). This is an example of the _________ type of risk category?
- A. nurse-focused
- B. physician-focused
- C. medical-legal incident
- D. Patient-focused
Correct Answer: C
Rationale: The correct answer is C: medical-legal incident. When a client discharges AMA, it poses medical-legal risks for healthcare providers. This includes potential liability if the client experiences adverse outcomes post-discharge. Other choices are incorrect because discharging AMA is not solely focused on nurses (A) or physicians (B), but involves legal implications. It is also not purely patient-focused (D) as it impacts the healthcare team's legal responsibilities.
The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select all that apply.)
- A. Expected length of stay
- B. Assigned healthcare team
- C. Patient outcomes
- D. Medical history
Correct Answer: C
Rationale: Rationale:
- Patient outcomes are essential in a critical pathway for CHF to track progress and effectiveness of interventions.
- Expected length of stay is not a core component but can be useful for resource planning.
- Assigned healthcare team is important but not a core component in the critical pathway.
- Medical history is relevant but not essential in the development of a critical pathway for CHF.
In a multiple-car accident with multiple trauma clients being sent to an Emergency Department, which type of leadership would be most effective in this situation?
- A. Democratic
- B. Bureaucratic
- C. Laissez-faire
- D. Autocratic
Correct Answer: D
Rationale: The correct answer is D: Autocratic leadership. In a high-stress, time-sensitive situation like a multiple-car accident with multiple trauma clients, autocratic leadership is most effective due to its clear chain of command and quick decision-making. The leader can provide swift direction, prioritize tasks, and ensure immediate action to save lives. Democratic leadership (A) may lead to delays in decision-making. Bureaucratic leadership (B) focuses on following procedures, which may not be suitable for urgent situations. Laissez-faire leadership (C) lacks direction and can result in chaos in a crisis.
Although technology has seen many advances, which two ethical principles may be in conflict because of technology?
- A. Beneficence and justice
- B. Beneficence and nonmaleficence
- C. Beneficence and veracity
- D. Beneficence and confidentiality
Correct Answer: B
Rationale: The correct answer is B: Beneficence and nonmaleficence. Beneficence refers to doing good and nonmaleficence refers to avoiding harm. Technology can create ethical conflicts because advancements may aim to benefit individuals (beneficence) but could also potentially cause harm (nonmaleficence). Other choices are incorrect: A) Justice is about fairness in distribution, not in conflict with beneficence; C) Veracity is truth-telling, not in direct conflict with beneficence; D) Confidentiality involves privacy, which is not directly in conflict with beneficence.
An RN’s current patient and family have presented her with an ethical dilemma. What is the first step the RN should take to find a workable solution to the problem?
- A. Planning
- B. Assessment
- C. Evaluation
- D. Implementation
Correct Answer: B
Rationale: The correct answer is B: Assessment. The first step in resolving an ethical dilemma is to thoroughly assess the situation. This involves gathering all relevant information, understanding the perspectives of the patient and family, and identifying key ethical principles at stake. Assessment allows the RN to have a clear understanding of the dilemma and its implications before proceeding with any planning, implementation, or evaluation. Planning (A), Implementation (D), and Evaluation (C) are all important steps in the problem-solving process, but without a comprehensive assessment, the RN may not have a solid foundation to address the ethical dilemma effectively.