Nokea
A patient is placed on reserpine (Serpalan) to decrease mild anxiety and treat hypertension. The patient researches the medication on the Internet and finds that this medication comes from which plant?
- A. Atropa belladonna
- B. Digitalis purpurea
- C. Rauwolfia serpentina
- D. Cephaelis ipecacuanha
Correct Answer: C
Rationale: The correct answer is C: Rauwolfia serpentina. Reserpine is derived from the Rauwolfia serpentina plant. This plant contains alkaloids that act as a central nervous system depressant, reducing anxiety and lowering blood pressure. Atropa belladonna (A) contains toxic alkaloids, Digitalis purpurea (B) contains cardiac glycosides used for heart conditions, and Cephaelis ipecacuanha (D) contains emetine used for inducing vomiting, none of which are related to reserpine's effects.
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A hospital's policy requires that all nurse managers must have a minimum of a bachelor's degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to physicians and staff, "The new nurse manager has book sense but no leadership abilities." What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit?
- A. Send memos to all staff except the upset nurse to invite them to a luncheon.
- B. Ask management to transfer the upset nurse to another unit.
- C. Assign the upset nurse to committees that do not directly affect that nursing unit.
- D. Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication.
Correct Answer: D
Rationale: Step 1: Acknowledge the clinical expertise of the upset nurse - This shows respect for the upset nurse's experience and expertise.
Step 2: Clearly explain the expectations for teamwork - Setting clear expectations fosters a collaborative environment.
Step 3: Emphasize open, honest communication - Encouraging open dialogue helps address concerns and build trust among the team.
Overall, option D is the best approach as it combines acknowledging the upset nurse's expertise, setting expectations for teamwork, and promoting open communication, which are crucial for gaining trust and respect among the nursing staff.
Summary of other choices:
A: Sending memos excludes the upset nurse and may create further resentment.
B: Transferring the upset nurse does not address the issue and may lead to more conflict.
C: Assigning the upset nurse to unrelated committees may isolate them and not address the underlying problem of lack of trust and respect on the unit.
Which component of budgeting might normally be addressed in the annual performance evaluation for a nurse manager?
- A. Including in the labor budget costs for overtime and benefits
- B. Managing variances in nursing overtime costs and supply usage
- C. Accurately predicting revenues on the basis of unit-of-service
- D. Providing qualitative analysis for variances in the capital budget
Correct Answer: B
Rationale: Step 1: Managing variances in nursing overtime costs and supply usage is crucial for a nurse manager's performance evaluation as it demonstrates their ability to control expenses effectively.
Step 2: This component directly relates to the nurse manager's responsibility in budgeting and financial management.
Step 3: Analyzing and managing variances show the nurse manager's skill in monitoring and adjusting budgetary allocations to meet targets.
Step 4: Other choices are not directly related to the nurse manager's core responsibilities in budgeting or evaluating performance.
Step 5: Labor budget costs for overtime and benefits (Choice A) and predicting revenues (Choice C) are important but not as directly tied to performance evaluation as managing variances in costs.
Step 6: Providing qualitative analysis for variances in the capital budget (Choice D) is not typically a key aspect of a nurse manager's evaluation, as it focuses more on long-term investments rather than day-to-day operational budgeting.
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 state is devastated by a tornado killing many people, destroying communication systems, utility services, homes, and medical facilities. The state requests immediate assistance from the U.S. Congress and from surrounding states. The affected state should first contact the:
- A. Emergency Management Assistance Compact (EMAC).
- B. Institute of Medicine (IOM).
- C. Red Cross.
- D. Strategic National Stockpile.
Correct Answer: A
Rationale: The correct answer is A: Emergency Management Assistance Compact (EMAC).
1. EMAC is a mutual aid agreement among states for disaster response.
2. It allows affected states to request and receive assistance from other states.
3. It facilitates coordination and deployment of resources quickly in emergencies.
4. IOM focuses on health research, Red Cross on humanitarian aid, and Strategic National Stockpile on medical supplies, but they do not provide the immediate multi-sectoral assistance needed in this scenario.
A registered nurse is on break and checking e-mails. One e-mail contains a picture of a celebrity who is a patient in the hospital, and on the same floor, where the nurse works. Included with the photo is a message, "check out my Facebook," which contains additional photographs of the patient. The nurse immediately deletes the picture to prevent having to report the "friend" to supervisors. Based on the action of the nurse who received the message, which statement is correct?
- A. The nurse is not at risk for having his or her license suspended since removing the photos made them temporary and invisible to all others.
- B. Because the nurse did not send the message and immediately deleted the photo, there is no risk for discipline.
- C. Failing to report receiving the message demonstrates poor ethical and legal role-modeling as well as placing the nurse at risk for discipline.
- D. Because the patient is on the same floor as the one on which the nurse works, the information can be ethically and legally shared.
Correct Answer: C
Rationale: The correct answer is C. The nurse is at risk for discipline because failing to report the receipt of the message demonstrates poor ethical and legal role-modeling. By deleting the photo and not reporting the incident, the nurse is not upholding patient confidentiality and is potentially violating privacy laws. Sharing patient information, even if the patient is on the same floor, is unethical and illegal. Choices A and B are incorrect because simply deleting the photos does not absolve the nurse from potential consequences, and not being the sender does not excuse the nurse from being responsible for maintaining patient confidentiality. Choice D is incorrect because sharing patient information without authorization is a violation of ethical and legal standards.