Contemporary Ethical Issues in Nursing

Contemporary Ethical Issues in Nursing Related

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A hospital's policy requires that all nurse managers must have a minimum of a bachelor's degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to physicians and staff, "The new nurse manager has book sense but no leadership abilities." What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit?

  • A. Send memos to all staff except the upset nurse to invite them to a luncheon.
  • B. Ask management to transfer the upset nurse to another unit.
  • C. Assign the upset nurse to committees that do not directly affect that nursing unit.
  • D. Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication.
Correct Answer: D

Rationale: Step 1: Acknowledge the clinical expertise of the upset nurse - This shows respect for the upset nurse's experience and expertise.
Step 2: Clearly explain the expectations for teamwork - Setting clear expectations fosters a collaborative environment.
Step 3: Emphasize open, honest communication - Encouraging open dialogue helps address concerns and build trust among the team.
Overall, option D is the best approach as it combines acknowledging the upset nurse's expertise, setting expectations for teamwork, and promoting open communication, which are crucial for gaining trust and respect among the nursing staff.

Summary of other choices:
A: Sending memos excludes the upset nurse and may create further resentment.
B: Transferring the upset nurse does not address the issue and may lead to more conflict.
C: Assigning the upset nurse to unrelated committees may isolate them and not address the underlying problem of lack of trust and respect on the unit.

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An RN delegates to the unlicensed assistive personnel (UAP) the task of performing blood pressure checks for a group of patients on a nursing unit. The UAP accepts the task and is responsible for:

  • A. delegating the task to another UAP if he or she does not have the time or skill to complete the task.
  • B. keeping the RN informed of any abnormal blood pressure readings.
  • C. calling the physician when the patient's vital signs are not within established parameters.
  • D. informing the dietary department to initiate a low-sodium diet for patients who are hypertensive.
Correct Answer: B

Rationale: The correct answer is B because keeping the RN informed of any abnormal blood pressure readings is an essential part of the UAP's responsibility. This ensures that the RN is aware of any potential issues with the patients' health and can intervene if necessary. It is important for the UAP to communicate such vital information promptly to the RN, who has the clinical expertise to assess the situation and make appropriate decisions.

Choice A is incorrect because the UAP should not delegate tasks to another UAP without prior authorization from the RN. Choice C is incorrect because calling the physician directly is beyond the scope of practice for a UAP. Choice D is incorrect because initiating a low-sodium diet for hypertensive patients is a clinical decision that should be made by the RN or physician, not the UAP.

A nurse working in a factory performs routine hearing tests for employees. The factory uses 90 dB as the safe limit for an 8-hour day's exposure to machine noise rather than 85 dB as recommended by the Occupational Safety and Health Administration. The nurse is functioning in the role of:

  • A. quality management.
  • B. informatics nurse specialist.
  • C. occupational health nurse.
  • D. case manager.
Correct Answer: C

Rationale: The correct answer is C: occupational health nurse. This is because an occupational health nurse specializes in promoting health and safety in the workplace, including monitoring employees' exposure to occupational hazards like noise. By conducting hearing tests and recognizing the discrepancy between the factory's safe noise level and OSHA's recommendation, the nurse is fulfilling the role of an occupational health nurse.

Choice A (quality management) is incorrect as it involves ensuring high-quality care and services, not specifically focused on workplace health and safety. Choice B (informatics nurse specialist) is incorrect as it pertains to using technology and data to improve healthcare outcomes, not directly related to workplace health monitoring. Choice D (case manager) is incorrect as it involves coordinating care for individual patients, not overseeing workplace health and safety practices.

The nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers is called a:

  • A. nurse manager.
  • B. case manager.
  • C. coordinator of patient-centered care delivery.
  • D. team leader in team nursing care delivery.
Correct Answer: B

Rationale: The correct answer is B: case manager. A case manager is responsible for coordinating care for a patient from admission to discharge, collaborating with various healthcare providers. This role involves managing the patient's overall care plan, ensuring continuity and efficiency. The other choices are incorrect because:
A: Nurse manager focuses on managing nursing staff and unit operations, not individual patient care.
C: Coordinator of patient-centered care delivery may oversee care coordination but does not necessarily follow the patient throughout the entire care journey.
D: Team leader in team nursing care delivery is focused on leading a specific nursing team, not managing the patient's entire care process.

A patient with kyphosis is visiting a practitioner of chiropractic medicine for the first time and asks, "How does this therapy work?" The practitioner replies, "I will use my hands along with heat to correct the misalignment of your spine by placing pressure on the nerves that have produced pain. The misalignment of your spine is referred to as:

  • A. subluxation."
  • B. a sprain."
  • C. a fracture."
  • D. epicondylitis."
Correct Answer: A

Rationale: The correct answer is A: subluxation. Subluxation in chiropractic terms refers to the misalignment of the vertebrae in the spine, which can put pressure on nerves and cause pain. Chiropractors believe that by using manual adjustments, they can correct these subluxations and restore proper alignment, which can alleviate pain and improve overall health. The other choices, B: a sprain, C: a fracture, and D: epicondylitis, do not accurately describe the misalignment of the spine that is being addressed in chiropractic care. Sprain refers to ligament injury, fracture refers to bone breakage, and epicondylitis refers to inflammation of the tendons.

Which statement related to delegation is correct?

  • A. The practice of unlicensed assistive personnel (UAP) is defined in the nurse practice act.
  • B. Nursing practice can be delegated only when the LPN/LVN and UAP have received adequate training.
  • C. Supervision is not required when routine tasks are delegated to a competent individual.
  • D. The RN must be knowledgeable about the laws and regulations that govern nursing practice, as well as those that have no clearly defined parameters, such as for UAP.
Correct Answer: D

Rationale: The correct answer is D because the RN must have knowledge of laws and regulations governing nursing practice, including those that have unclear boundaries for UAP. This is crucial to ensure safe and effective delegation. Option A is incorrect because the nurse practice act typically does not define UAP roles. Option B is incorrect as delegation also requires assessing competency, not just training. Option C is incorrect as supervision is necessary regardless of the task's routine nature. The correct answer emphasizes the importance of legal knowledge for proper delegation.

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