Nokea
A novice nurse is unsure of his ability to insert a nasogastric tube for one of the assigned patients who is vomiting coffee ground emesis. The novice nurse waits, hoping that someone with more experience will volunteer to do the job, or he just waits until the end of the shift. This nurse is practicing:
- A. energy management.
- B. priority setting.
- C. procrastination.
- D. introspection.
Correct Answer: C
Rationale: The correct answer is C: procrastination. Procrastination is the act of delaying or avoiding a task that needs to be accomplished. In this scenario, the novice nurse is avoiding the task of inserting a nasogastric tube for a patient who needs it due to uncertainty and fear. Waiting for someone else to volunteer or delaying the task until the end of the shift are clear examples of procrastination. Energy management (A) involves efficiently allocating time and resources, which is not demonstrated here. Priority setting (B) would involve recognizing the urgency of the situation and taking appropriate action. Introspection (D) refers to self-reflection and analyzing one's thoughts and feelings, which is not the primary issue at hand in this scenario.
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A client and her husband used in vitro fertilization to become pregnant. The unused sperm was frozen so the couple could have more children later. The husband is killed while in combat, and the client journals her choices and the possible ramifications. She comes to the fertility clinic after looking at the situation from many perspectives and after considering many alternatives. She asks that the sperm be destroyed because her husband's faith prohibited remarrying, and allowing another person to use the sperm would conflict with her late husband's beliefs. The nurse realizes that:
- A. the client is in the second step of ethical decision making and that the client's value system is influencing her choices of alternative actions.
- B. a logical line of reasoning has led to validation of the decision to destroy the husband's sperm.
- C. the client has not been able to navigate the complicated issues inherent in this situation.
- D. a rational decision was reached that was based on reflection and on the value systems of the wife and the husband.
Correct Answer: D
Rationale: The correct answer is D because the client's decision to destroy the husband's sperm was based on reflection and the value systems of both the wife and the husband. Firstly, the client considered her late husband's faith and beliefs, showing reflection on his values. Secondly, she analyzed the situation from various perspectives and considered alternatives, indicating a rational decision-making process. This decision was reached after careful consideration of ethical and moral implications, demonstrating a logical and reasoned approach. In contrast, choices A and C imply shortcomings in the client's decision-making process, while choice B focuses solely on validation without considering the underlying reasoning. Therefore, choice D is the most appropriate as it aligns with the client's thoughtful and value-based decision-making process.
In attempting to decide which services should be offered to a community, the public health nurse decides to implement hypertension screening and treatment because most of the residents are hypertensive. This decision is based on the principle of:
- A. veracity.
- B. values.
- C. utilitarianism.
- D. autonomy.
Correct Answer: C
Rationale: The correct answer is C: utilitarianism. Utilitarianism is the ethical principle that actions should be chosen based on their ability to maximize overall happiness or well-being. In this scenario, implementing hypertension screening and treatment for a community where most residents are hypertensive aligns with utilitarianism as it aims to benefit the greatest number of people by improving their health outcomes. This decision focuses on the overall good of the community, making it the most ethical choice.
Rationale for why other choices are incorrect:
A: Veracity is the principle of truthfulness. While honesty is important in healthcare decision-making, it is not the primary factor in this scenario.
B: Values refer to personal beliefs and principles. While values may influence decision-making, the primary focus in this scenario is on maximizing community health outcomes.
D: Autonomy is the principle of respecting individuals' right to make their own decisions. While autonomy is important in healthcare, it is not the guiding principle in this scenario where the focus is
A recruiter is explaining benefits to a group of nursing externs who are highly sought for employment. The recruiter states, "We are the only hospital in town that offers a residency program." The recruiter further explains that a residency program:
- A. provides housing for the graduate nurse to decrease expenses until income is established.
- B. partners a medical resident with a nurse resident to learn interprofessional care.
- C. allows new graduates to work on a higher degree in nursing while being paid full-time.
- D. offers extended time for both theory and clinical activities that promote problem solving and clinical decision making.
Correct Answer: D
Rationale: The correct answer is D because a residency program offers extended time for both theory and clinical activities that promote problem-solving and clinical decision-making skills. This is important for new graduates to enhance their clinical skills and transition into practice effectively.
A: Providing housing for the graduate nurse is not typically a component of a residency program.
B: Partnering a medical resident with a nurse resident for interprofessional care is not a defining feature of a nursing residency program.
C: Allowing new graduates to work on a higher degree in nursing while being paid full-time is not the primary focus of a nursing residency program, which is more about developing clinical skills.
A nurse who was recently certified in chemotherapy administration fails to check compatibility of phenytoin (Dilantin) before injecting into a continuous infusion of D W leading to occlusion of the line. Which statement by the nurse demonstrates a red herring?
- A. The nurse is upset and states, "I am sure I have injected this before without a problem" and the supervisor interprets this to mean the nurse often take shortcuts.
- B. The nurse states, "You are just upset because I am certified in chemotherapy administration and you are not."
- C. "The nurse who started the IV didn't get a blood return but determined the IV was the patient's"that is the problem."
- D. "This drug always occludes the line because it is so viscous."
Correct Answer: D
Rationale: The correct answer is D because it is a red herring statement that distracts from the main issue. Phenytoin is not known to be viscous enough to cause line occlusion. Step 1: Identify the issue - failure to check compatibility. Step 2: A, B, and C address the issue directly or indirectly, while D deflects blame to the drug's viscosity. Step 3: A acknowledges the mistake, B deflects by attacking the supervisor, and C blames the IV setup. In summary, D is incorrect as it diverts attention from the main issue, making it a red herring.
In the preparedness phase for disasters, the community plans for a possible terrorist attack using anthrax as the weapon of destruction. What treatments and/or preparations would be needed?
- A. Vaccines and Level B Personal Protection Equipment (PPE)
- B. Treatment for burns, decontamination, and Level A PPE
- C. Social distance determination, decontamination for radioactive fallout
- D. Identify and detect incendiary devices, treatment for burns and propellants
Correct Answer: A
Rationale: The correct answer is A: Vaccines and Level B Personal Protection Equipment (PPE). In the preparedness phase for a terrorist attack using anthrax, vaccines are crucial for prevention. Level B PPE provides respiratory protection and skin protection against anthrax spores. This is essential for healthcare workers and first responders.
Choice B is incorrect as it mentions treatment for burns, which is not relevant to anthrax exposure. Decontamination and Level A PPE are not specifically needed for anthrax. Choice C is incorrect as it mentions radioactive fallout, which is not relevant to anthrax. Social distancing is also not effective in preventing anthrax exposure. Choice D is incorrect as it mentions incendiary devices and treatment for burns, which are not related to anthrax exposure. Identifying and detecting propellants is also not relevant to anthrax preparedness.