Nokea
A nurse is caring for a dying client whose family wants to be with him in the operating suite. The surgeon, however, does not allow families to be present during surgery. The nurse recognizes this as an ethical dilemma. What is the initial step of the nurse when managing this situation?
- A. Contact the physician to amend the order for the client
- B. Document an account of the situation to ensure adequate coverage of details
- C. Consult with the medical ethics committee to determine a safe and workable solution
- D. Speak with the chief nursing officer to change the policy governing this situation
Correct Answer: A
Rationale: The correct initial step is to choose option A: Contact the physician to amend the order for the client. This is the most appropriate action because the conflict arises from the surgeon's policy, which can potentially be changed with physician involvement. By discussing the situation with the physician, the nurse can advocate for the family's wishes and potentially negotiate a compromise. This step prioritizes the client's and family's needs while also respecting the surgeon's authority. Options B, C, and D are not the initial steps because they involve escalating the situation before attempting direct communication with the physician, which can be seen as bypassing the appropriate chain of command.
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Which of the following is an example of a living will?
- A. A client's son has been appointed to make his healthcare decisions if he becomes incapacitated
- B. A client has designated which of his children will receive his home and property before he dies
- C. A client has instructions that he does not want to be resuscitated through chest compressions if his heart stops beating
- D. A client designates what type of burial or cremation services he would want after his death
Correct Answer: C
Rationale: The correct answer is C because a living will is a legal document that outlines a person's preferences for medical treatment in case they are unable to communicate their wishes. In this case, the client's instruction not to be resuscitated through chest compressions if his heart stops beating is an example of a living will. This choice specifically addresses medical treatment preferences during a critical health situation.
Choices A, B, and D are incorrect because they all involve decisions or instructions that pertain to events or actions after the client's death, rather than specifying medical treatment preferences while the client is alive. Choice A involves appointing someone to make healthcare decisions, choice B involves designating inheritance of property, and choice D involves specifying burial or cremation services. These choices do not align with the purpose of a living will, which is to provide guidance for medical treatment decisions during the client's lifetime.
Research participants are involved in a trial that incidentally separates them into two groups. One group receives an intervention, while the other group does not. Both groups are compared for outcomes. What type of research method is this?
- A. Experimental design
- B. Double-blind experiment
- C. Randomized controlled trial
- D. Repeated measures design
Correct Answer: C
Rationale: The correct answer is C: Randomized controlled trial (RCT). In an RCT, participants are randomly assigned to either the intervention group or the control group, ensuring that both groups are similar at the start of the trial. This minimizes bias and allows for comparing the outcomes of the intervention group with the control group. This design helps establish a cause-effect relationship between the intervention and the outcomes.
Choice A (Experimental design) is not specific enough as there are various types of experimental designs. Choice B (Double-blind experiment) refers to a study where neither the participants nor the researchers know who is receiving the intervention, which is not the case here. Choice D (Repeated measures design) involves measuring the same participants at different time points, not separating them into different groups.
A client is refusing to undergo any more treatments in the hospital and wants to leave against medical advice. When the nurse requests the client to sign an AMA order, the client refuses and leaves. What is the next action of the nurse?
- A. Call security to hold the client until he signs the order
- B. Notify the physician to convince the client to stay
- C. Speak with the client's spouse to persuade him to stay
- D. Allow the client to leave and document the refusal in his chart
Correct Answer: D
Rationale: The correct answer is D: Allow the client to leave and document the refusal in his chart. This is the appropriate action because every individual has the right to refuse medical treatment, even if it is against medical advice. By allowing the client to leave and documenting the refusal in the chart, the nurse respects the client's autonomy and ensures legal and ethical considerations are met. Calling security to hold the client (choice A) would violate the client's rights. Notifying the physician to convince the client (choice B) may not be effective and goes against the client's autonomy. Speaking with the client's spouse (choice C) is irrelevant as the decision lies with the client.
Upon admission to the stroke care unit of a rehabilitation center, what is the primary action of the nurse?
- A. Collect and organize documents for the client's medical record
- B. Prepare the client's identification bracelet
- C. Identify pertinent health history data and current needs and limitations
- D. Gather the client's valuables and secure them in a locked container
Correct Answer: C
Rationale: The correct answer is C because identifying pertinent health history data and current needs and limitations is crucial in developing an individualized care plan for the stroke patient. This data helps determine the appropriate interventions and therapies needed for the client's recovery. Collecting and organizing documents (choice A) can be important but not the primary action. Preparing an identification bracelet (choice B) and gathering valuables (choice D) are important tasks but not the immediate priority upon admission.
A nurse is caring for an in-patient client in the hospital who is from another country and who fasts for temporary periods in order to promote his own spiritual growth. The nurse responds by saying, 'You need to eat something while you are here. Food and proper nutrition are extremely important for your health.' What social philosophy is the nurse demonstrating?
- A. Ethnocentrism
- B. Relativism
- C. Stereotyping
- D. Xenocentrism
Correct Answer: A
Rationale: The correct answer is A: Ethnocentrism. Ethnocentrism is the belief in the inherent superiority of one's own culture or ethnic group. In this scenario, the nurse is imposing their own cultural beliefs about food and nutrition onto the patient, without considering or respecting the patient's cultural or spiritual practices. This demonstrates a lack of cultural sensitivity and understanding, as the nurse is prioritizing their own cultural norms over the patient's beliefs.
Summary of other choices:
B: Relativism - Relativism would involve acknowledging and respecting the patient's cultural practices and beliefs, which the nurse is not doing in this case.
C: Stereotyping - Stereotyping involves making assumptions about individuals based on their cultural background, which is not explicitly demonstrated in this scenario.
D: Xenocentrism - Xenocentrism is the opposite of ethnocentrism, where one believes that other cultures are superior to their own. This is not evident in the nurse's behavior.