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Which action by a patient indicates that the home health nurse’s teaching about glargine and
regular insulin has been successful?
- A. The patient administers the glargine 30 minutes before each meal
- B. The patient’s family prefills the syringes with the mix of insulins weekly.
- C. The patient draws up the regular insulin and then the glargine in the same syringe.
- D. The patient disposes of the open vials of glargine and regular insulin after 4 weeks
Correct Answer: D
Rationale: Step 1: Glargine and regular insulin should not be mixed in the same syringe as they have different onset and duration of action.
Step 2: Administering glargine 30 minutes before each meal is incorrect as it is a long-acting insulin.
Step 3: Pre-filling syringes weekly with the mix of insulins can lead to incorrect dosing or contamination.
Step 4: Disposing of open vials after 4 weeks is the correct action to ensure potency and safety of the insulin.
Summary: Choice D is correct because it demonstrates proper insulin storage and disposal practices. Choices A, B, and C are incorrect as they involve incorrect administration techniques or storage practices.
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Which agency reviews whether an organization meets its own criteria for staffing?
- A. American Nurses Association (ANA)
- B. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
- C. Patient Classification Systems (PCSs)
- D. Nursing Care Hours (NCHs)
Correct Answer: B
Rationale: The correct answer is B: Joint Commission on Accreditation of Healthcare Organizations (JCAHO). JCAHO is responsible for accrediting healthcare organizations and ensuring they meet specific standards, including staffing requirements. They review whether an organization meets its own criteria for staffing to ensure quality care. The other choices (ANA, PCSs, NCHs) are not specifically focused on accrediting organizations or evaluating staffing criteria, making them incorrect options.
A nurse manager asks the staff to submit written suggestions for a change in policy. The group would then vote on the different suggestions. What type of decision-making technique did the nurse manager use?
- A. Statistical aggregation
- B. Nominal group technique
- C. Brainstorming
- D. Delphi
Correct Answer: B
Rationale: The correct answer is B: Nominal group technique. The nurse manager used this technique by asking staff to submit written suggestions, which are then voted on collectively. In nominal group technique, group members generate ideas individually, then share and discuss them as a group to reach a decision. This technique encourages equal participation, prevents domination by vocal members, and ensures all ideas are considered fairly.
A: Statistical aggregation involves combining data or opinions to reach a numerical result, not individual suggestions.
C: Brainstorming is a technique where a group generates ideas freely without immediate evaluation or criticism.
D: Delphi method involves gathering input from experts anonymously to reach a consensus, which is different from voting on written suggestions.
A registered nurse (RN) is caring for a patient who is one of Jehovah’s Witnesses and has refused a blood transfusion even though her hemoglobin is dangerously low. After providing information about all the alternatives available and risks and benefits of each, the health-care provider allows the patient to determine which course of treatment she would prefer. The RN knows this is an example of which ethical principle?
- A. Autonomy
- B. Nonmaleficence
- C. Beneficence
- D. Distributive justice
Correct Answer: A
Rationale: The correct answer is A: Autonomy. Autonomy refers to the patient's right to make their own decisions about their healthcare, including the choice to refuse treatment. In this scenario, the healthcare provider respects the patient's autonomy by providing information and allowing her to make an informed decision, even if it goes against medical advice. This upholds the patient's right to self-determination and control over her own body.
Summary:
B: Nonmaleficence - This principle focuses on doing no harm to the patient, but in this case, respecting the patient's autonomy takes precedence.
C: Beneficence - This principle involves acting in the patient's best interest, but in this scenario, respect for autonomy is the primary consideration.
D: Distributive justice - This principle is about fair distribution of resources and care, which is not directly relevant to the patient's right to make decisions about her own treatment.
When in opposition to an immediate superior, a nurse manager should use which important strategy in a confrontation?
- A. Using 'I' language
- B. Using absolutes
- C. Using 'why' questions
- D. Using negative assertions
Correct Answer: A
Rationale: The correct answer is A: Using 'I' language. This strategy is effective in confrontation as it focuses on expressing one's own thoughts and feelings without blaming the other person. By using "I" language, the nurse manager can communicate assertively and take ownership of their perspective, which can lead to a more constructive dialogue.
Summary:
B: Using absolutes can come across as rigid and may escalate the confrontation.
C: Using 'why' questions can be perceived as accusatory and defensive, potentially leading to further conflict.
D: Using negative assertions can create a hostile environment and hinder effective communication.
There are several pitfalls that should be avoided when using social media of any type. For example, a nurse or student could be found guilty of libel in which of the following scenarios?
- A. Snapping a selfie with a patient
- B. Posting a positive review of the hospital where the student completed clinicals
- C. Creating a closed online forum where students can discuss clinical experiences without providing client information
- D. Complaining about her nurse preceptor on social media, discussing the preceptor’s unprofessional characteristics.
Correct Answer: D
Rationale: The correct answer is D because complaining about a nurse preceptor on social media and discussing their unprofessional characteristics can be considered libel if it damages the preceptor's reputation. This action violates professional and ethical standards by publicly criticizing a colleague.
A: Snapping a selfie with a patient is a breach of patient privacy but not necessarily libel.
B: Posting a positive review of the hospital is not libelous.
C: Creating a closed forum to discuss clinical experiences without client information is not libelous as long as confidentiality is maintained.