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A nurse who sits on the hospitals ethics committee is reviewing a complex case that has many of the hallmarks of assisted suicide. Which of the following would be an example of assisted suicide?
- A. Administering a lethal dose of medication to a patient whose death is imminent
- B. Administering a morphine infusion without assessing for respiratory depression
- C. Granting a patients request not to initiate enteral feeding when the patient is unable to eat
- D. Neglecting to resuscitate a patient with a do not resuscitate order
Correct Answer: A
Rationale: The correct answer is A because administering a lethal dose of medication to a patient whose death is imminent directly causes the patient's death, constituting assisted suicide. This action is intentional and aims to end the patient's life. In contrast, choices B, C, and D do not involve intentionally causing the patient's death. Choice B involves a medication error but not with the intent to end the patient's life. Choice C respects the patient's autonomy in refusing treatment. Choice D honors the patient's wishes for end-of-life care. Thus, only choice A aligns with the definition of assisted suicide.
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The nurse is caring for a patient newly diagnosed with a primary brain tumor. The patient asks the nurse where his tumor came from. What would be the nurses best response?
- A. Your tumor originated from somewhere outside the CNS.
- B. Your tumor likely started out in one of your glands.
- C. Your tumor originated from cells within your brain itself.
- D. Your tumor is from nerve tissue somewhere in your body.
Correct Answer: C
Rationale: The correct answer is C because primary brain tumors originate from cells within the brain itself. These tumors develop from abnormal growth of brain cells. Choice A is incorrect as primary brain tumors do not come from outside the central nervous system (CNS). Choice B is incorrect as primary brain tumors do not typically start in glands. Choice D is incorrect as primary brain tumors do not arise from nerve tissue elsewhere in the body. In summary, the nurse should explain to the patient that the tumor originated from cells within his brain to provide accurate information about the nature of primary brain tumors.
A blood-soaked peripad weighs 900 g. The nurse would document a blood loss of _____ mL.
- A. 1800
- B. 450
- C. 900
- D. 90
Correct Answer: C
Rationale: The correct answer is C (900 mL) because the weight of 900 g corresponds to a blood loss of the same amount in milliliters. Blood density is close to that of water, so 1 g ≈ 1 mL. Therefore, a blood-soaked peripad weighing 900 g indicates a blood loss of 900 mL. Choice A (1800 mL) is incorrect as it doubles the weight instead of converting it to milliliters. Choice B (450 mL) is incorrect as it halves the weight. Choice D (90 mL) is incorrect as it divides the weight by 10, which is too small for the blood loss indicated.
An older adult with a recent history of mixed hearing loss has been diagnosed with a cholesteatoma. What should this patient be taught about this diagnosis? Select all that apply
- A. Cholesteatomas are benign and self-limiting, and hearing loss will resolve spontaneously.
- B. Cholesteatomas are usually the result of metastasis from a distant tumor site.
- C. Cholesteatomas are often the result of chronic otitis media.
- D. Cholesteatomas, if left untreated, result in intractable neuropathic pain. E) Cholesteatomas usually must be removed surgically.
Correct Answer: C
Rationale: The correct answer is C. Cholesteatomas are often the result of chronic otitis media. Chronic otitis media can lead to the formation of cholesteatomas, which are noncancerous but can cause complications if left untreated. Cholesteatomas do not resolve spontaneously (A), are not the result of metastasis (B), do not typically cause intractable neuropathic pain (D), and usually require surgical removal to prevent complications (E). Therefore, educating the patient about the association between chronic otitis media and cholesteatoma is essential for understanding the diagnosis and potential treatment options.
A patient has just been told that her illness is terminal. The patient tearfully states, I cant believe I am going to die. Why me? What is your best response?
- A. I know how you are feeling.
- B. You have lived a long life.
- C. This must be very difficult for you.
- D. Life can be so unfair.
Correct Answer: C
Rationale: The correct answer is C: "This must be very difficult for you." This response acknowledges the patient's emotional state and shows empathy without making assumptions or dismissing their feelings. It validates the patient's emotions and opens up the opportunity for further discussion or support.
Rationale:
1. A: "I know how you are feeling" assumes the tutor knows the exact emotions of the patient, which can come off as insincere or dismissive.
2. B: "You have lived a long life" does not address the patient's emotional distress or provide comfort in the face of a terminal illness.
3. D: "Life can be so unfair" does not directly address the patient's feelings and may come off as generic or cliché.
Which behaviors indicate the student nurse hasa good understanding of confidentiality and the Health Insurance Portability and Accountability Act (HIPAA)? (Selectall that apply.)
- A. Writes the patient’s room number and date of birth on a paper for school
- B. Prints/copies material from the patient’s health record for a graded care plan
- C. Reviews assigned patient’s record and another unassigned patient’s record
- D. Gives a change-of-shift report to the oncoming nurse about the patient
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
- Giving a change-of-shift report to the oncoming nurse about the patient is an appropriate action that maintains confidentiality by only sharing necessary patient information with authorized healthcare professionals.
- A: Writing the patient’s room number and date of birth on a paper for school is a breach of confidentiality as it exposes sensitive patient information to unauthorized individuals.
- B: Printing/copying material from the patient’s health record for a graded care plan is also a breach of confidentiality as it involves sharing patient information without proper authorization.
- C: Reviewing assigned patient’s record and another unassigned patient’s record is a violation of HIPAA as it involves accessing patient information that is not necessary for the nurse's duties, risking unauthorized disclosure.