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A nurse is caring for a client with malignant hypertension whose blood pressure has increased by 40 mm Hg during the past hour. The nurse goes to lunch and fails to report the change to the physician. The nurse is at risk for being charged with:
- A. negligence.
- B. assault.
- C. defamation of character.
- D. tort.
Correct Answer: A
Rationale: Correct Answer: A - Negligence
Rationale:
1. Negligence is the failure to provide the standard of care resulting in harm to the patient.
2. The nurse failed to report a significant change in the patient's condition, breaching the duty of care.
3. The increase in blood pressure could lead to serious complications, indicating the severity of negligence.
Summary:
B: Assault - Involves intentional threat or harm, not applicable in this scenario.
C: Defamation of character - Involves false statements damaging reputation, not relevant in the context of patient care.
D: Tort - A broader legal term encompassing various civil wrongs, but negligence is a specific type of tort applicable here.
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Which nursing theory might a nurse use as a conceptual framework to determine how to meet the needs of immigrants while ensuring provision of high-quality and culturally sensitive care?
- A. Martha Rogers' nursing theory
- B. Dorothea Orem's nursing theory
- C. Hildegard Peplau's nursing theory
- D. Madeleine Leininger's nursing theory
Correct Answer: D
Rationale: The correct answer is D, Madeleine Leininger's nursing theory. Leininger's Cultural Care Theory emphasizes the importance of providing culturally congruent care to individuals, taking into account their cultural beliefs, values, and practices. This theory is particularly relevant when caring for immigrants as it helps nurses understand and address their unique cultural needs.
A: Martha Rogers' nursing theory focuses on the science of unitary human beings and energy fields, not specifically on cultural care.
B: Dorothea Orem's nursing theory, the Self-Care Deficit Theory, emphasizes the individual's ability to perform self-care activities, not specifically cultural care.
C: Hildegard Peplau's nursing theory, the Theory of Interpersonal Relations, focuses on the nurse-patient relationship and therapeutic communication, not specifically on cultural care for immigrants.
The nurse caring for a patient states, "Your blood pressure is dangerously high. Are you taking antihypertensive medicine?" The patient states, "I can't afford my medicine. I have no insurance." The nurse states "I feel really sorry for that patient. I wish it wasn't against policy to give her money." The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that "She was so sick last evening when she came to the ED. I can't believe they don't provide insurance. I can't give her money but you all can help." This nurse:
- A. is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines.
- B. is at risk for HIPAA violations.
- C. has properly followed policy and protected the patient by not using her name.
- D. is demonstrating the logical fallacy of slippery slope.
Correct Answer: B
Rationale: The correct answer is B because the nurse is at risk for HIPAA violations by sharing patient information on social media. The Health Insurance Portability and Accountability Act (HIPAA) protects patients' privacy and prohibits healthcare providers from disclosing their health information without consent. In this scenario, the nurse shared specific details about the patient's health condition, visit to the ED, and financial situation, which could easily identify the patient. This violates the patient's right to privacy and confidentiality. Choices A, C, and D are incorrect because the focus should be on the HIPAA violation rather than empathy, policy following, or logical fallacies. The nurse should have found alternative ways to help the patient without compromising their privacy.
A client is admitted with chest pain. A series of diagnostic tests are ordered, and the client undergoes coronary artery bypass grafting. The cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (ICU) stay by 3 days because of respiratory problems. The case manager realizes that under the terms of the diagnosis-related group (DRG) payment system for this diagnosis:
- A. the cost of caring for this client was $5000 greater than the DRG reimbursement fee, and the hospital will be allowed to collect the additional fees from the insurance company.
- B. although the cost of care for this client was greater than the DRG reimbursement amount, the hospital will be reimbursed only at the set fee.
- C. the client will be sued to pay back the insurance company for the extra fees incurred because smoking is a modifiable health risk for heart disease.
- D. the physician who admitted the client will receive a reduced payment to cover the loss incurred by the hospital.
Correct Answer: B
Rationale: The correct answer is B. The DRG payment system is a fixed reimbursement amount for a specific diagnosis or procedure. In this case, the cost of care exceeded the DRG reimbursement amount due to the extended ICU stay caused by the client's smoking history. The hospital will only be reimbursed at the set fee specified by the DRG, regardless of the actual cost incurred.
Choice A is incorrect because the hospital cannot collect additional fees from the insurance company beyond the DRG reimbursement amount. Choice C is incorrect as the client is not typically held responsible for the additional costs incurred. Choice D is incorrect because physician payment is not directly impacted by the hospital's financial losses. The DRG system focuses on fixed reimbursements based on diagnoses, not individual physician payments.
A student nurse is preparing a presentation that requires identification of outcomes for the care of heart failure patients. Which is a correctly written outcome?
- A. Develop a teaching program to address physical activities that result in improved cardiac function.
- B. Discuss the clinical manifestations associated with Level 4 heart failure.
- C. List the most common pharmaceutical approaches to reduce preload in heart failure patients.
- D. Recognize the economic impact that recidivism has on the patient and health care facility.
Correct Answer: A
Rationale: The correct answer is A because it specifies a measurable and achievable goal related to improving cardiac function through physical activities. It follows the SMART criteria (Specific, Measurable, Achievable, Relevant, Time-bound). Option B does not provide a specific outcome, while Option C focuses on pharmaceutical approaches rather than outcomes. Option D is unrelated to the goal of improving outcomes for heart failure patients. Thus, option A is the most appropriate choice for a well-defined and relevant outcome for the care of heart failure patients.
Nurses entering the workforce at a large urban hospital soon began volunteering for excessive overtime. A focus group found that upon graduation, many of these nurses purchased expensive cars and furniture. They lacked skills in managing their checkbook and were often unable to pay recurring bills; this finding would be relevant to which component of the Workforce Advocacy Ecosystem Model?
- A. Staffing
- B. Workflow design
- C. Organizational factors
- D. Personal and social factors
Correct Answer: D
Rationale: The correct answer is D: Personal and social factors. This finding is relevant to personal and social factors because it highlights the individual behaviors and financial decisions of the nurses entering the workforce. The nurses' lack of financial management skills and tendency to overspend on luxury items indicate personal factors influencing their ability to handle their finances effectively. Additionally, their social environment, such as peer influences or societal pressure to display wealth, could also contribute to their financial struggles.
Incorrect choices:
A: Staffing - This choice focuses on the recruitment and deployment of staff, which is not directly related to the nurses' personal financial management issues.
B: Workflow design - This choice pertains to how tasks are organized and coordinated within the workplace, which is not directly related to the nurses' personal financial challenges.
C: Organizational factors - This choice refers to the broader context of the hospital's policies, culture, and structures, which may indirectly influence the nurses' financial behaviors but are not as directly related as personal and social factors