Nokea
A nurse uses critical thinking every day when going through the nursing process. Which of the following is an outcome of critical thinking in nursing practice?
- A. A comprehensive plan of care with a high potential for success
- B. Identification of the nurses preferred goals for the patient
- C. A collaborative basis for assigning care
- D. Increased cost efficiency in health care
Correct Answer: A
Rationale: Critical thinking in nursing practice results in a comprehensive plan of care with maximized potential for success. Critical thinking does not identify the nurses goal for the patient or provide a collaborative basis for assigning care. Critical thinking may or may not lead to increased cost efficiency; the patients outcomes are paramount.
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A medical nurse is caring for a patient who is palliative following metastasis. The nurse is aware of the need to uphold the ethical principle of beneficence. How can the nurse best exemplify this principle in the care of this patient?
- A. The nurse tactfully regulates the number and timing of visitors as per the patients wishes.
- B. The nurse stays with the patient during his or her death.
- C. The nurse ensures that all members of the care team are aware of the patients DNR order.
- D. The nurse liaises with members of the care team to ensure continuity of care.
Correct Answer: B
Rationale: Beneficence is the duty to do good and the active promotion of benevolent acts. Enacting the patients wishes around visitors is an example of this. Each of the other nursing actions is consistent with ethical practice, but none directly exemplifies the principle of beneficence.
A nurse provides care on an orthopedic reconstruction unit and is admitting two new patients, both status post knee replacement. What would be the best explanation why their care plans may be different from each other?
- A. Patients may have different insurers, or one may qualify for Medicare.
- B. Individual patients are seen as unique and dynamic, with individual needs.
- C. Nursing care may be coordinated by members of two different health disciplines.
- D. Patients are viewed as dissimilar according to their attitude toward surgery.
Correct Answer: B
Rationale: Regardless of the setting, each patient situation is viewed as unique and dynamic. Differences in insurance coverage and attitude may be relevant, but these should not fundamentally explain the differences in their nursing care. Nursing care should be planned by nurses, not by members of other disciplines.
The nurse caring for a patient who is two days post hip replacement notifies the physician that the patients incision is red around the edges, warm to the touch, and seeping a white liquid with a foul odor. What type of problem is the nurse dealing with?
- A. Collaborative problem
- B. Nursing problem
- C. Medical problem
- D. Administrative problem
Correct Answer: A
Rationale: In addition to nursing diagnoses and their related nursing interventions, nursing practice involves certain situations and interventions that do not fall within the definition of nursing diagnoses. These activities pertain to potential problems or complications that are medical in origin and require collaborative interventions with the physician and other members of the health care team. The other answers are incorrect because the signs and symptoms of infection are a medical complication that requires interventions by the nurse.
A nurse has been using the nursing process as a framework for planning and providing patient care. What action would the nurse do during the evaluation phase of the nursing process?
- A. Have a patient provide input on the quality of care received.
- B. Remove a patients surgical staples on the scheduled postoperative day.
- C. Provide information on a follow-up appointment for a postoperative patient.
- D. Document a patients improved air entry with incentive spirometric use.
Correct Answer: D
Rationale: During the evaluation phase of the nursing process, the nurse determines the patients response to nursing interventions. An example of this is when the nurse documents whether the patients spirometry use has improved his or her condition. A patient does not do the evaluation. Removing staples and providing information on follow-up appointments are interventions, not evaluations.
While receiving report on a group of patients, the nurse learns that a patient with terminal cancer has granted power of attorney for health care to her brother. How does this affect the course of the patients care?
- A. Another individual has been identified to make decisions on behalf of the patient.
- B. There are binding parameters for care even if the patient changes her mind.
- C. The named individual is in charge of the patients finances.
- D. There is a document delegating custody of children to other than her spouse.
Correct Answer: A
Rationale: A power of attorney is said to be in effect when a patient has identified another individual to make decisions on her behalf. The patient has the right to change her mind. A power-of-attorney for health care does not give anyone the right to make financial decisions for the patient nor does it delegate custody of minor children.