Contemporary Issues in Nursing

Contemporary Issues in Nursing Related

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A nurse who has practiced on an orthopedic unit for 10 years unexpectedly becomes pregnant. At delivery the physician informs the mother, "Your baby has Alport syndrome, but then I don't have to explain what that means with your medical background." The mother is unfamiliar with this disease and withdraws as a coping mechanism. Which nursing theory would provide a framework to guide nursing care for this mother?

  • A. Mishel's uncertainty of illness
  • B. Orem's self-care deficit model
  • C. Nightingale's canons of nursing
  • D. Levine's conservation model
Correct Answer: A

Rationale: The correct answer is A: Mishel's uncertainty of illness. This theory focuses on how individuals cope with uncertainty related to illness or health events. In this scenario, the mother is facing unexpected news about her baby's condition, causing her to withdraw as a coping mechanism due to the uncertainty she is experiencing. By utilizing Mishel's theory, nurses can provide support and guidance to help the mother navigate her feelings of uncertainty and develop coping strategies.

Choice B (Orem's self-care deficit model) is not the best fit as it primarily focuses on the individual's ability to perform self-care activities, which may not directly address the mother's emotional response to uncertainty. Choice C (Nightingale's canons of nursing) is more focused on the environmental factors impacting health and may not address the mother's coping needs. Choice D (Levine's conservation model) emphasizes maintaining stability and balance in the body systems, which may not directly address the mother's emotional needs in coping with uncertainty.

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A graduate nurse should begin the job search knowing that:

  • A. few jobs are available for RNs because of a failing health care economy.
  • B. it would be more promising to apply to a rural hospital than to an urban hospital.
  • C. although efforts have been made to reduce expenditures for health care, the need for RNs remains stable.
  • D. the demand for nurses to work in acute care hospitals has decreased because most services are being shifted to outpatient and ambulatory settings.
Correct Answer: C

Rationale: The correct answer is C because efforts to reduce healthcare expenditures do not necessarily impact the need for RNs, which remains stable. This is supported by the ongoing demand for nurses in various healthcare settings. Choice A is incorrect as the demand for RNs is generally high. Choice B is incorrect because job availability depends on various factors beyond just the location of the hospital. Choice D is incorrect as the need for nurses in acute care hospitals remains significant despite the shift towards outpatient and ambulatory settings.

An RN with a diploma preparation wants to participate in decisions about health care and decides the first step is to obtain a BSN. The nurse enrolls in a nursing program offering self-scheduling and a self-paced curriculum. This nurse is taking advantage of:

  • A. educational mobility.
  • B. a traditional nursing program.
  • C. training for advanced practice nursing.
  • D. credit by examination.
Correct Answer: A

Rationale: Rationale for Correct Answer (A - educational mobility):
1. Educational mobility refers to the ability to move between different levels of education in nursing.
2. The nurse with a diploma seeking a BSN is utilizing educational mobility by advancing to a higher level of education.
3. Choosing a program with self-scheduling and a self-paced curriculum allows for flexibility, facilitating educational mobility.

Summary of Incorrect Choices:
B: Traditional nursing programs typically have fixed schedules and structured curricula, not aligned with self-paced learning.
C: Training for advanced practice nursing involves pursuing education beyond a BSN to become an advanced practice nurse, not directly related to obtaining a BSN.
D: Credit by examination allows students to earn credits based on prior knowledge, but it does not specifically relate to pursuing a BSN for educational mobility.

A nurse explaining the above graph indicates the frequency of falls in 2011 to detect and possibly explain causes of variation. The peaks in June were attributed to regular staff vacations during which agency nurses were used. The nurse is employed in which role?

  • A. Case Manager
  • B. Quality Manager
  • C. Forensic Nurse
  • D. Occupational Health Nurse
Correct Answer: B

Rationale: Step 1: The nurse's role involves analyzing data to identify causes of variation in falls, indicating a focus on quality improvement.
Step 2: As a Quality Manager, the nurse is responsible for monitoring and improving the quality of care provided.
Step 3: Case Managers focus on coordinating patient care, Forensic Nurses deal with legal aspects, and Occupational Health Nurses focus on workplace health.
Step 4: Therefore, the nurse's role aligns most closely with a Quality Manager in this scenario, making choice B the correct answer.

A nurse who is licensed in Georgia and moves to Oregon:

  • A. must check Oregon's nurse practice act related to licensure for endorsement.
  • B. will automatically be grandfathered in as a licensed registered nurse.
  • C. may request certification in Oregon rather than licensure, so as not to have to retake the NCLEX-RN®.
  • D. should contact the American Nurses Credentialing Center to determine whether he or she is eligible to practice in an another state.
Correct Answer: A

Rationale: The correct answer is A because when a nurse moves to a new state, they must check the new state's nurse practice act related to licensure for endorsement. This is important to ensure the nurse meets all requirements and regulations for practicing in the new state. Option B is incorrect as licensure is not automatically transferred. Option C is incorrect as certification is different from licensure, and the NCLEX-RN® is typically required for licensure. Option D is incorrect as the American Nurses Credentialing Center is not responsible for determining state licensure eligibility. Checking the new state's nurse practice act is the standard procedure for obtaining licensure endorsement.

A client is hypertensive, and the doctor prescribes weight reduction. The client is excited about beginning the diet, but on arriving home the spouse states, "You have always been fat, and I am not going to starve because you can't control yourself." The client becomes anxious and is unable to participate in the diet plan, resulting in a weight gain of 5 pounds in 2 weeks. Which theorist could best be referred to for guidance regarding interventions in this situation?

  • A. Martha E. Rogers
  • B. Hildegard E. Peplau
  • C. Florence Nightingale
  • D. Myra Estrin Levine
Correct Answer: B

Rationale: The correct answer is B: Hildegard E. Peplau. Peplau's nursing theory focuses on interpersonal relations, emphasizing the nurse-client relationship. In this situation, the client's anxiety and inability to participate in the diet plan are directly related to the negative interaction with the spouse. Peplau's theory suggests that the nurse can intervene by providing emotional support, facilitating communication, and helping the client manage anxiety. Rogers' theory focuses on the science of unitary human beings, which is not directly applicable here. Nightingale's theory emphasizes environmental factors, not interpersonal relationships. Levine's theory focuses on conservation principles, which are not directly relevant to addressing the client's anxiety and relational issues. Therefore, Peplau's theory best guides interventions in this situation.

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