Nokea
A group of nurses meet with a state representative to explain the importance of allowing registered nurses the right to sign death certificates for patients who were under their care. As constituents and nurses, they requested that the senator vote against the bill restricting this practice. These nurses are serving as:
- A. lobbyists.
- B. policymakers.
- C. officials with regulatory power.
- D. advocates for the Patient Safety and Quality Improvement Act.
Correct Answer: A
Rationale: The correct answer is A: lobbyists. The nurses are acting as lobbyists by advocating for a specific cause (allowing RNs to sign death certificates) to the state representative. They are not policymakers (B) because they are not directly making decisions or creating policies. They are also not officials with regulatory power (C) as they are not in a position to enforce regulations. Lastly, they are not advocating for the Patient Safety and Quality Improvement Act (D) specifically in this scenario.
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A nurse is preparing to teach a class related to risk factors for cancer to a diverse ethnic group attending a health fair. The nurse should be aware:
- A. that Hispanic women overestimate the prevalence of cancer and strictly following breast self-examination guidelines.
- B. of the importance of risk factors such as smoking and alcohol consumption that increase esophageal cancer when speaking with black.
- C. that American-Indian women have a higher rate of ovarian cancer than the general population.
- D. that cancer as well as heart disease and stroke are lower in ethnic groups.
Correct Answer: C
Rationale: The correct answer is C because it provides accurate information about a specific risk factor related to a particular ethnic group. American-Indian women do have a higher rate of ovarian cancer than the general population, making it crucial for the nurse to be aware of this when teaching about cancer risk factors.
A is incorrect as it discusses breast cancer and not ovarian cancer. B is incorrect as it mentions esophageal cancer, which is not the specific focus of the question. D is also incorrect as it makes a general statement about cancer, heart disease, and stroke in ethnic groups without providing specific information about ovarian cancer in American-Indian women.
A peaceful death is best characterized by which terminally ill patient?
- A. One who is surrounded by family
- B. One who uses meditation to help manage pain
- C. One who has advanced directives in place
- D. One who has drifted from lethargy to coma
Correct Answer: A
Rationale: The correct answer is A because being surrounded by family provides emotional support, comfort, and a sense of closure. Family presence can alleviate fear, anxiety, and loneliness, contributing to a peaceful death experience. Choice B focuses on pain management but does not address emotional well-being. Choice C, while important for end-of-life care, does not directly impact the patient's immediate comfort. Choice D indicates a decline in consciousness, which may not necessarily lead to a peaceful death experience as the patient may not be aware of their surroundings or loved ones.
A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency?
- A. Safety
- B. Timely
- C. Equitable
- D. Patient-centered care
Correct Answer: A
Rationale: The correct answer is A: Safety. The team of nurses developing algorithms and checklists aims to ensure standardization of procedures, which directly relates to patient safety. Safety is a fundamental competency in healthcare, as it involves minimizing harm to patients. Standardization through checklists helps reduce errors and promote consistency in care delivery. Timely care (B) focuses on providing care promptly, equitable care (C) emphasizes fairness and eliminating disparities, and patient-centered care (D) prioritizes individual preferences and needs. While these competencies are important in healthcare, in this scenario, the team's primary focus on standardization aligns with the safety competency.
A client states, "I am leaving. No one here knows what they are doing." The nurse completing the Against Medical Advice form must:
- A. defer notifying the provider until the client has had ample time to leave.
- B. state in medical terms the risks of leaving.
- C. inform the client that leaving could result in complications and impairment.
- D. detain the person with the use of soft restraints until security arrives.
Correct Answer: C
Rationale: Rationale: Choice C is correct because informing the client of potential complications and impairment is essential to ensure the client makes an informed decision. This aligns with the principle of autonomy and informed consent. Choice A is incorrect as delaying notification can jeopardize the client's safety. Choice B is incorrect because using medical jargon may not effectively communicate the risks to the client. Choice D is incorrect as using restraints is a violation of the client's rights and autonomy.
A priority action for the nurse who works with culturally diverse clients is completion of a:
- A. sign language course.
- B. cultural self-assessment.
- C. cultural client assessment.
- D. continuing education course on how to speak Spanish.
Correct Answer: B
Rationale: The correct answer is B: cultural self-assessment. This is important as it helps the nurse understand their own beliefs, values, and biases, which can impact how they interact with culturally diverse clients. By being self-aware, the nurse can better recognize and address any potential cultural misunderstandings or conflicts.
A: Taking a sign language course is not the priority as not all culturally diverse clients are deaf or use sign language.
C: While cultural client assessment is important, it is secondary to the nurse understanding their own cultural biases first.
D: Taking a course on how to speak Spanish is helpful but may not address the broader cultural competence needed to work with diverse clients.