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A nurse walks into a client's room to find the nursing assistant yelling, 'Sit back down or I won't help you eat, and then you will starve!' This type of behavior is known as:
- A. Psychological abuse
- B. Abandonment
- C. Material exploitation
- D. Physical abuse
Correct Answer: A
Rationale: The correct answer is A: Psychological abuse. This behavior involves verbal threats and emotional manipulation, causing fear and distress to the client. It violates the client's rights and dignity. Abandonment (B) refers to deserting a client in need. Material exploitation (C) involves misuse of a client's property or resources. Physical abuse (D) involves causing harm through physical force.
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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.
A client asks a nurse, 'Do you think I should move back home after this procedure?' and the nurse responds by saying, 'Do you think you should move back home?' What type of therapeutic communication is the nurse representing?
- A. Observation
- B. Reflection
- C. Summarizing
- D. Validating
Correct Answer: B
Rationale: The correct answer is B: Reflection. Reflection involves paraphrasing the client's words to help them explore their feelings and thoughts. In this scenario, the nurse is reflecting the client's question back to them, encouraging self-exploration. Observation (A) involves stating what the nurse sees or hears without interpretation. Summarizing (C) involves condensing information. Validating (D) involves confirming the client's feelings or experiences. The nurse's response does not align with the other options, making reflection the best choice.
Which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal?
- A. The adolescent gives away a DVD player and a cherished autographed picture of a performer.
- B. The adolescent runs out of group therapy, swearing at the group leader, and then goes to her room.
- C. The adolescent becomes angry while speaking on the phone and slams down the receiver.
- D. The adolescent gets angry with her roommate when the roommate borrows her clothes without asking.
Correct Answer: A
Rationale: The correct answer is A because giving away cherished possessions can be a sign of preparing for suicide. This behavior may indicate a lack of concern for material possessions due to a belief that they won't be needed in the future. Choice B shows anger and isolation, not necessarily suicidal ideation. Choice C demonstrates anger but no indication of suicidal thoughts. Choice D shows anger towards the roommate, not self-harm intentions.
A nursing unit is implementing a new electronic charting program for the nursing staff to use. Which of the following best describes a disadvantage of using electronic charting?
- A. The information is more likely to be lost or used inappropriately.
- B. Any provider in the unit can have access to the client's medical records.
- C. The system diminishes communication between nurses and providers.
- D. The program may be confusing and difficult to implement.
Correct Answer: D
Rationale: The correct answer is D: The program may be confusing and difficult to implement. Implementing a new electronic charting program may be challenging due to the complexity of the software and the learning curve for staff. It can take time and resources to train employees on how to effectively use the program, leading to potential confusion and resistance to change. This disadvantage could result in delays in charting, errors, and frustrations among staff members.
Other choices are incorrect because:
A: The information is more likely to be lost or used inappropriately - Electronic charting systems often have built-in security measures to prevent data loss and unauthorized access.
B: Any provider in the unit can have access to the client's medical records - Electronic charting systems have role-based access control to limit who can view specific patient information.
C: The system diminishes communication between nurses and providers - Electronic charting can actually improve communication by allowing real-time access to patient information.
Which method is most appropriate for managing moral distress in the workplace?
- A. Recognizing that life is unfair and nurses cannot meet every need of every client
- B. Declining to act when clients or visitors make requests that are not justifiable
- C. Developing a new policy that would address the problematic situation
- D. Both A and B
Correct Answer: C
Rationale: The correct answer is C. Developing a new policy is the most appropriate method for managing moral distress in the workplace because it addresses the root cause of the problematic situation. By creating a policy, organizations can provide clear guidelines and procedures to handle ethical dilemmas, thus empowering healthcare professionals to navigate moral challenges effectively.
Choice A is incorrect as it encourages acceptance of unfairness and could lead to moral disengagement. Choice B is also incorrect as declining to act in unjustifiable situations can compromise patient care and violate ethical principles. Choice D is incorrect as it combines two flawed approaches that do not effectively address moral distress. Developing a new policy is the most proactive and systematic approach to managing moral distress in the workplace.