Contemporary Issues in Nursing

Contemporary Issues in Nursing Related

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A nurse is asked to "float" to another area where the patients require total care. The nurse smiles, picks up her stethoscope, and says, "I'll come back and eat lunch with everyone here." When she enters the elevator she hits the wall and mutters, "Always me. Don't I have any rights"? The nurse is demonstrating which communication style?

  • A. Assertive
  • B. Aggressive
  • C. Passive
  • D. Passive-aggressive
Correct Answer: D

Rationale: The correct answer is D, passive-aggressive. The nurse is indirectly expressing her displeasure and resistance to floating by smiling and agreeing to come back for lunch, but then displaying negative body language and muttering under her breath. This behavior is passive on the surface but aggressive in the underlying tone. The nurse is not openly confronting the issue but is still showing resistance and frustration.

A: Assertive communication involves expressing one's needs and feelings in a direct and respectful manner. The nurse is not openly communicating her feelings or needs in this scenario.
B: Aggressive communication involves expressing needs and feelings in a forceful and hostile manner. The nurse's behavior is not openly hostile towards others.
C: Passive communication involves avoiding conflict and not expressing one's needs or feelings. The nurse is indirectly expressing her displeasure, so it's not purely passive.

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A nursing student planning to apply for licensure knows that being charged with which offense would result in a minor criminal offense?

  • A. Solicitation of illegal drugs
  • B. Stealing a car
  • C. Failing to report elder abuse
  • D. Billing Medicare for services not rendered
Correct Answer: A

Rationale: The correct answer is A: Solicitation of illegal drugs. This offense typically results in a minor criminal offense because it involves attempting to purchase or obtain illegal drugs, which is considered a less serious crime compared to the other choices. Stealing a car (B) is a major criminal offense, as it involves theft of property. Failing to report elder abuse (C) is a serious offense as it neglects the duty to protect vulnerable individuals. Billing Medicare for services not rendered (D) is a form of fraud and can result in severe consequences. Therefore, the solicitation of illegal drugs is the least serious offense among the options provided.

A patient is admitted with pneumoniThe case manager refers to a plan of care that specifically identifies dates when supplemental oxygen should be discontinued, positive-pressure ventilation with bronchodilators should be changed to self-administered inhalers, and antibiotics should be changed from intravenous to oral treatment, on the basis of assessment findings. This plan of care is referred to as a:

  • A. patient classification system.
  • B. clinical pathway.
  • C. patient-centered plan of care.
  • D. diagnosis-related group (DRG).
Correct Answer: B

Rationale: The correct answer is B: clinical pathway. A clinical pathway is a detailed plan of care that outlines specific interventions and treatments based on assessment findings to guide patient care in a structured manner. In this case, the plan includes specific dates for discontinuing supplemental oxygen, changing ventilation methods, and transitioning antibiotics.

A. Patient classification system: This refers to categorizing patients based on certain criteria for resource allocation and staffing levels, not specific care plans.

C. Patient-centered plan of care: While patient-centered care focuses on individual preferences and needs, it does not necessarily include the structured timeline and interventions outlined in a clinical pathway.

D. Diagnosis-related group (DRG): DRGs are used for billing and payment purposes based on specific diagnoses, not for detailed care plans like the one described in the question.

An older adult client was admitted to the hospital with the condition classified as "pneumonia." Reimbursement was based on a predetermined fixed price. This classification system is referred to as:

  • A. diagnosis-related groups (DRGs).
  • B. subjective symptom management.
  • C. acuity classification system.
  • D. organized managed care.
Correct Answer: A

Rationale: The correct answer is A: diagnosis-related groups (DRGs). This classification system assigns a fixed price to specific diagnoses or procedures, such as pneumonia, for reimbursement purposes. DRGs aim to standardize payment based on patient diagnosis and treatment, promoting efficiency and cost containment in healthcare.

B: Subjective symptom management is not a classification system for reimbursement but rather a method of addressing patient symptoms.

C: Acuity classification system refers to determining the level of care a patient needs based on severity, not reimbursement.

D: Organized managed care involves coordination of healthcare services and providers, not specific classification for reimbursement.

The nurse who admits making a medication error and immediately files an incident report is demonstrating:

  • A. accountability.
  • B. individuality.
  • C. an injustice.
  • D. values clarification.
Correct Answer: A

Rationale: The correct answer is A: accountability. By admitting the error and filing an incident report, the nurse is taking responsibility for their actions, being transparent, and willing to face the consequences. This demonstrates professionalism and integrity. Choice B is incorrect because it does not address the nurse's responsibility. Choice C is incorrect as it does not relate to the nurse's actions. Choice D is incorrect as values clarification is not demonstrated by admitting an error and reporting it.

The nurse is preparing a plan of care for an black patient who has had a change of bowel habits from being constipated and having only two firm stools weekly to having three or more loose stools daily. Which comment is related to cultural variation for health information?

  • A. The individual states, "I will need to discuss health care options with my grandmother."
  • B. The eldest male member of the family will make all health care decisions.
  • C. The patient has high respect for the nurse and nods approvingly, although she has no intention of complying with instructions or plan of care.
  • D. The individual speaks very quietly and gently reaches to hold the nurse's hand for support.
Correct Answer: A

Rationale: The correct answer is A because it reflects the patient's cultural variation in seeking health information from family members, specifically the grandmother. This shows respect for family opinions and involvement in decision-making.

Option B is incorrect as it generalizes that the eldest male makes all health decisions, which may not be true for every cultural group. Option C is incorrect as nodding approvingly and not complying with instructions does not necessarily indicate cultural variations. Option D is incorrect as speaking quietly and reaching for the nurse's hand may simply indicate a patient's communication style rather than cultural variation in seeking health information.

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