Nokea
A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed:
- A. honeymoon.
- B. shock or rejection.
- C. recovery.
- D. resolution.
Correct Answer: B
Rationale: The correct answer is B: shock or rejection. This phase of reality shock is characterized by feelings of being overwhelmed, confused, and unsure of how to proceed despite having knowledge. The novice nurse is experiencing a sense of rejection towards the situation due to the gap between theoretical knowledge and practical application. This phase is common among new healthcare professionals as they transition from academic learning to real-world clinical practice.
A: Honeymoon phase refers to the initial period of excitement and enthusiasm in a new role.
C: Recovery phase is when the individual starts to adapt and become more comfortable with the new role.
D: Resolution phase is the final stage where the individual fully integrates into the role and becomes confident and competent.
In this scenario, the novice nurse is clearly struggling and feeling overwhelmed, indicating that they are in the shock or rejection phase, making choice B the correct answer.
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Which trend is an effect of the nursing shortage on nursing education?
- A. Only devoted qualified nurses are continuing to provide bedside nursing because of the complexity of care required, resulting in excellent preceptorships for students.
- B. The number of applicants to nursing programs has risen, but enrollment is limited because of a decrease in the number of available scholarships and grants.
- C. With an increase in the number of nurses who are entering graduate school to escape bedside nursing, students will soon enjoy a lower faculty/student ratio.
- D. Students may be assigned to preceptors who have not yet developed expertise in the field of interest.
Correct Answer: D
Rationale: The correct answer is D because the nursing shortage has led to a situation where students may be assigned to preceptors who have not yet developed expertise in the field of interest. This is a direct effect of the shortage as experienced and qualified nurses may not always be available to mentor students. This can impact the quality of education and training students receive, potentially hindering their learning and skill development.
Options A, B, and C are incorrect:
A: While it is true that devoted qualified nurses may be providing bedside nursing due to the complexity of care required, this does not directly relate to the effect of the nursing shortage on nursing education.
B: The increase in the number of applicants and limited enrollment due to financial reasons is a separate issue from the shortage's impact on nursing education.
C: The increase in nurses entering graduate school does not necessarily result in a lower faculty/student ratio for nursing students and is not a direct effect of the nursing shortage on nursing education.
Which statements concerning licensure as a registered nurse are correct? (select all that apply)
- A. Nurses who graduate from different types of nursing education programs are granted different types of licenses, those with a baccalaureate degree having the most expanded role.
- B. A nursing license cannot be revoked, only suspended.
- C. Each nurse practice act describes requirements for initial licensure.
- D. It is illegal for states to ask about the mental or physical status of an applicant.
Correct Answer: A
Rationale: Rationale:
A: Correct. Nurses with different education levels (e.g., associate vs. bachelor's degree) have varied scope of practice. BSN-prepared nurses typically have a broader scope compared to ADN-prepared nurses.
B: Incorrect. Nursing licenses can be revoked or suspended for various reasons such as misconduct or negligence.
C: Incorrect. Nurse practice acts outline licensure requirements, but not specifically for initial licensure.
D: Incorrect. States may inquire about the mental or physical status of applicants to ensure they are fit to practice safely.
Three illegal immigrants with no health insurance or money sustained life-threatening injuries during an automobile accident. Two of these individuals had head trauma and lacerated internal organs. The decision was made to provide extended care in the trauma center after emergency surgery was performed to save their lives. The third individual received only minor injuries, which were treated in the emergency department. The care of the two critical clients was based on the ethical principle of:
- A. utilitarianism.
- B. deontology.
- C. autonomy.
- D. veracity.
Correct Answer: A
Rationale: The correct answer is A: utilitarianism. Utilitarianism is an ethical principle that focuses on maximizing overall well-being and minimizing harm. In this scenario, the decision to provide extended care to the two critical individuals with life-threatening injuries aligns with utilitarianism as it prioritizes saving the most lives and reducing suffering. By choosing to allocate resources to those with the most severe injuries, the healthcare providers are aiming to maximize the overall benefit to society.
Summary of why the other choices are incorrect:
B: Deontology focuses on following rules and duties regardless of the consequences. In this case, the decision to provide care based on severity of injuries goes against a strict deontological approach.
C: Autonomy emphasizes respecting individuals' rights to make their own decisions about their care, which is not the primary consideration in this scenario.
D: Veracity pertains to honesty and truthfulness in communication, which is not directly relevant to the decision-making process in this healthcare scenario.
When practicing in a compact state:
- A. the nurse must abide solely by the practice act of the largest state.
- B. patients' rights in relation to the nurse practice act are protected by the mutual recognition model.
- C. the nurse must pay for a license in all states that participate in the mutual recognition model.
- D. the nurse must refer to the nurse practice act for the list of skills that can be performed.
Correct Answer: B
Rationale: The correct answer is B because in a compact state, the mutual recognition model allows nurses to practice across state lines without obtaining additional licenses. This model ensures that patients' rights are protected by requiring nurses to adhere to the nurse practice act of the state where the patient is located. This promotes nursing mobility while maintaining regulatory standards.
A is incorrect because nurses must follow the nurse practice act of the state where they are practicing, not necessarily the largest state. C is incorrect because nurses do not have to pay for a license in all participating states under the mutual recognition model. D is incorrect because the nurse practice act outlines the scope of practice, not necessarily the list of skills that can be performed across state lines.
A client is in extreme pain after he was involved in a motor vehicle accident, and morphine has been ordered every hour for pain. The nurse injects saline into the client's IV line and takes the morphine for herself. The nurse is violating which principle of ethics?
- A. Autonomy
- B. Utilitarianism
- C. Beneficence
- D. Dilemmas
Correct Answer: C
Rationale: The correct answer is C: Beneficence. Beneficence is the ethical principle that emphasizes the obligation to act in the best interest of the client and to do good. In this scenario, the nurse is not acting in the best interest of the client by withholding the prescribed medication for personal gain. This action goes against the principle of beneficence as it is causing harm to the client by denying them the necessary pain relief.
Summary:
A: Autonomy is the right of the client to make their own decisions, which is not the main issue in this scenario.
B: Utilitarianism focuses on maximizing overall good for the greatest number of people, which is not directly applicable here.
D: Dilemmas do not represent a specific ethical principle being violated in this situation.