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A nurse is caring for a client who is participating in a research study for an experimental chemotherapy medication. After three treatments, the experimental medication is discontinued due to evidence of rapidly advancing kidney failure. The nurse should understand discontinuing this medication demonstrates which of the following ethical principles?
- A. Veracity
- B. Fidelity
- C. Nonmaleficence
- D. Autonomy
Correct Answer: C
Rationale: The correct answer is C: Nonmaleficence. This principle of ethics requires healthcare providers to do no harm to their patients. In this scenario, discontinuing the experimental chemotherapy medication after evidence of rapidly advancing kidney failure demonstrates the nurse's commitment to preventing further harm to the client. By stopping the medication that is causing harm, the nurse is upholding the principle of nonmaleficence.
Other choices are incorrect:
A: Veracity - Veracity pertains to truthfulness and honesty in communication with patients. Discontinuing the medication is not related to truthfulness.
B: Fidelity - Fidelity refers to the obligation to fulfill commitments and promises made to patients. Discontinuing the medication is not about fulfilling commitments.
D: Autonomy - Autonomy is the right of patients to make their own decisions about their healthcare. Discontinuing the medication is not about respecting the patient's autonomy in this context.
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A nurse is planning care for a client who is 2 hours postoperative following a transurethral resection of the prostate. The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include?
- A. Restrict the client’s oral fluid intake.
- B. Remind the client he might feel a constant urge to void.
- C. Weigh the client every evening.
- D. Monitor the client’s urine output every 6 hours.
Correct Answer: B
Rationale: The correct answer is B: Remind the client he might feel a constant urge to void. After a transurethral resection of the prostate, continuous bladder irrigation is often used to prevent blood clots and ensure urine output. This procedure can cause the client to feel a constant urge to void due to the bladder being continuously filled and emptied. Therefore, reminding the client about this sensation can help alleviate anxiety and discomfort.
Choice A: Restricting the client's oral fluid intake is incorrect because maintaining hydration is essential postoperatively to prevent complications such as dehydration and urinary retention.
Choice C: Weighing the client every evening is unnecessary and not directly related to the care of a client post transurethral resection of the prostate.
Choice D: Monitoring the client's urine output every 6 hours is important, but reminding the client about the sensation of constant urge to void takes priority in this scenario.
A nurse is educating community members about how to prepare for a disaster. Which of the following items should be included in a disaster preparedness kit? (Select all that apply)
- A. Clean clothing.
- B. Personal identification.
- C. Three quarts of water per person.
- D. Matches.
- E. Prescription medications.
Correct Answer: A,B,D,E
Rationale: The correct items to include in a disaster preparedness kit are A, B, D, and E. Clean clothing (A) is essential for hygiene and warmth. Personal identification (B) is crucial for identification and accessing services. Matches (D) are necessary for starting fires for warmth and cooking. Prescription medications (E) are vital for individuals with medical conditions. Choice C is incorrect as the recommended amount of water for disaster preparedness is one gallon per person per day, not three quarts. Choices F and G are not provided in the question and therefore cannot be assessed.
A nurse is instructing a female client on obtaining a midstream urine specimen. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will wipe from the back to front with the cleaning cloth.
- B. I need to urinate a small amount in the toilet before collecting the sample.
- C. I should let the urine cool to room temperature before sending it to the lab.
- D. I should not collect a urine sample when I am menstruating.
Correct Answer: B
Rationale: Correct Answer: B - "I need to urinate a small amount in the toilet before collecting the sample."
Rationale:
1. This statement indicates the client understands the importance of collecting a midstream urine sample.
2. By urinating a small amount first, the initial stream clears any bacteria present in the urethra, ensuring a more accurate sample.
3. Collecting a midstream sample helps to avoid contamination from the surrounding genital area.
4. This method is essential for accurate urinalysis results and diagnosis of potential urinary tract infections.
Incorrect Choices:
A: Incorrect - Wiping from back to front can introduce bacteria from the anal region into the urethra, leading to contamination.
C: Incorrect - Cooling the urine to room temperature is not necessary for a midstream urine sample collection.
D: Incorrect - Menstruation does not interfere with the accuracy of a midstream urine sample collection.
A nurse is preparing a response protocol for botulism as a bioterrorism agent. The nurse should prepare the protocol based on which of the following information? (Select all that apply.)
- A. Botulism is acquired through direct contact with an infected person.
- B. Notify the Centers for Disease Control and Prevention (CDC) when more than three cases are confirmed.
- C. Botulism can produce paralysis within 12 to 72 hours following exposure.
- D. Vomiting and diarrhea are expected findings following exposure.
- E. Botulism is a toxin found in castor beans.
Correct Answer: C,D
Rationale: The correct answers are C and D. Choice C is correct because botulism can indeed produce paralysis within 12 to 72 hours following exposure. This is crucial information for early detection and treatment. Choice D is also correct because vomiting and diarrhea are not typical symptoms of botulism. The toxin primarily affects the nervous system, leading to symptoms such as muscle weakness and paralysis. Choices A, B, and E are incorrect. Botulism is not acquired through direct contact with an infected person (A), the CDC should be notified immediately upon suspicion of botulism, not after a certain number of cases (B), and botulism toxin is not found in castor beans (E).
A nurse is caring for a client who has just returned from the PACU after a traditional cholecystectomy. In which of the following positions should the nurse place the client?
- A. Supported Sims
- B. Semi-Fowler’s
- C. Dorsal recumbent
- D. Prone
Correct Answer: B
Rationale: The correct answer is B: Semi-Fowler’s position. Placing the client in Semi-Fowler’s position after a cholecystectomy helps to promote optimal lung expansion and oxygenation. This position reduces pressure on the diaphragm and abdomen, allowing for improved respiratory function. Additionally, it helps prevent complications such as atelectasis and pneumonia. Supported Sims position (A) is used for enemas, not post-cholecystectomy care. Dorsal recumbent position (C) is for pelvic exams, not indicated here. Prone position (D) would put pressure on the abdomen and is contraindicated post-cholecystectomy.