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A nurse is seeking to become culturally competent in regard to obtaining information during health history and when performing physical diagnosis. The nurse is aware that which biologic variation is found in all of the following ethnicities: blacks, Asians, Hispanics, and American Indians?
- A. Mongolian spots
- B. Sickle cell anemia
- C. Lactose intolerance
- D. Thalassemia
Correct Answer: B
Rationale: The correct answer is B: Sickle cell anemia. This genetic disorder is found in individuals of African, Asian, Hispanic, and American Indian descent. Sickle cell anemia is caused by a mutation in the hemoglobin gene, leading to the production of abnormal hemoglobin. This condition is more prevalent in these ethnic groups due to historical reasons and natural selection against malaria.
A: Mongolian spots are common in Asian infants but not in all the mentioned ethnicities.
C: Lactose intolerance is more common in individuals of African, Asian, and Hispanic descent but not specifically in American Indians.
D: Thalassemia is more prevalent in individuals of Mediterranean, African, and Southeast Asian descent, not in all the mentioned ethnicities.
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Which functions can be delegated only to another RN with appropriate experience and training? (select all that apply)
- A. Assessment of skin integrity on third day of hospitalization
- B. Evaluation of patient teaching related to turn, cough, and deep breathing exercises
- C. Nursing judgment related to withholding medication based on vital signs
- D. RNs do not delegate to other RNs, they delegate only to licensed practical nurses or unlicensed assistive personnel
Correct Answer: C
Rationale: The correct answer is C because nursing judgment related to withholding medication based on vital signs requires critical thinking, clinical knowledge, and experience. This decision-making process involves assessing the patient's condition, interpreting vital signs, and determining if medication should be given or withheld to ensure patient safety. This function cannot be delegated to someone without the appropriate training and expertise.
A: Assessment of skin integrity on the third day of hospitalization can be delegated to other healthcare team members such as LPNs or nursing assistants, as long as they have been trained and deemed competent.
B: Evaluation of patient teaching related to turn, cough, and deep breathing exercises can be delegated to other healthcare team members, as long as they have the appropriate training and supervision.
D: The statement that RNs do not delegate to other RNs is incorrect. RNs can delegate certain tasks to other RNs based on their scope of practice and level of experience. It is not limited to LPNs or unlicensed assistive personnel.
When the novice nurse asks, "What will happen if this task is not completed," which skill is being demonstrated?
- A. Priority setting
- B. Delegation
- C. Organization
- D. Clinical skills
Correct Answer: A
Rationale: The novice nurse is demonstrating priority setting by asking about the consequences of not completing a task. This skill involves determining the most crucial tasks to be completed first based on their potential impact on patient outcomes. By understanding the implications of task completion, the nurse can effectively prioritize their workload. Delegation involves assigning tasks to others, organization involves arranging tasks in a systematic way, and clinical skills refer to the technical abilities in providing patient care. These skills are not directly demonstrated by the nurse's question about the consequences of task completion.
An elderly person, age 80, is finding it difficult to live alone and the family is considering long-term care. The elderly person is reasonably healthy, with only normal aging declines, and maintains a healthy appetite. All medications are administered orally and require only minimal assistance. She is financially secure with an income based on retirement from both the military and factory from her deceased husband and herself. The family contacts long- term care and is told that, based on this patient's information:
- A. Medicare will cover the cost of stay since skilled services are required.
- B. Medicaid is only for families with dependent children.
- C. Medicare will pay for home health services should these additional services meet the needs of the individual.
- D. Medicare will pay regardless of household income or financial status for nursing home care.
Correct Answer: C
Rationale: Rationale for Correct Answer (C): Medicare will pay for home health services should these additional services meet the needs of the individual.
1. Medicare covers home health services for individuals who meet specific criteria, which may include being homebound, needing skilled nursing care, and having a care plan established by a healthcare provider.
2. In this scenario, the elderly person is reasonably healthy and only requires minimal assistance with oral medications, indicating that she may benefit from home health services rather than long-term care.
3. Since the elderly person is financially secure, it is likely that she does not meet the eligibility criteria for Medicaid, which is a need-based program for individuals with limited income and resources.
4. Medicare does not cover long-term care in a nursing home unless specific criteria are met, such as requiring skilled services on a short-term basis. In this case, the elderly person's need for assistance with oral medications does not necessarily qualify as a skilled service for nursing home care.
Summary of Incorrect Choices:
A
During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy?
- A. An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway.
- B. A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power.
- C. A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call.
- D. A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.
Correct Answer: A
Rationale: The correct answer is A because denying the older person with Alzheimer's disease the right to ambulate violates their autonomy by restricting their freedom to make choices about their own body and movement. Autonomy is the ethical principle that respects an individual's right to make decisions about their own health and well-being. In this situation, the person should have the autonomy to decide whether or not they want to ambulate, even if they have advanced Alzheimer's disease.
Choice B is incorrect because the mentally competent adult has the right to refuse medical treatment based on their beliefs, which is an expression of autonomy.
Choice C is incorrect because the mentally competent visitor has the right to refuse examination, which is also an expression of autonomy.
Choice D is incorrect because the mentally competent adult has the right to refuse a local anesthetic, which is also an expression of autonomy.
A nonprofit organization that distributes to governmental agencies, the public, business, and health care professionals knowledge related to health care for the purpose of improving health is the:
- A. Institute for Safe Medication Practices.
- B. Institute of Medicine.
- C. National Committee for Quality Assurance.
- D. The Joint Commission.
Correct Answer: B
Rationale: The correct answer is B: Institute of Medicine. The Institute of Medicine is known for disseminating knowledge related to health care through government agencies, the public, business, and health care professionals to improve health outcomes. The organization conducts research and provides evidence-based recommendations to address health care challenges.
A: Institute for Safe Medication Practices focuses specifically on promoting safe medication practices, not a broad range of health care knowledge dissemination.
C: National Committee for Quality Assurance primarily focuses on accrediting and certifying health care organizations based on quality standards, rather than broadly distributing health care knowledge.
D: The Joint Commission is responsible for accrediting health care organizations and institutions, ensuring they meet quality and safety standards, but not specifically for distributing health care knowledge to various stakeholders.