Ethics & Issues in Contemporary Nursing

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A patient presents with chest pain that increases when lying flat and low-grade fever. Assessment reveals muffled heart sounds, tachycardia, and 3+ edema in the lower extremities. The nurse asks the patient to learn forward, which eases respiratory efforts. The nurse then places the stethoscope at which area on the chest to facilitate auscultation? The above question represents which type of alternate-format question written at which level of Bloom's taxonomy?

  • A. Multiple-response item, comprehension level
  • B. Hot-spot item, analysis level
  • C. Chart/exhibit item, application level
  • D. Drag-and-drop item, knowledge level
Correct Answer: B

Rationale: The correct answer is B: Hot-spot item, analysis level. In this scenario, the patient's symptoms suggest pericardial effusion or cardiac tamponade. To facilitate auscultation, the nurse should place the stethoscope at the point of maximal intensity of the heart sounds, which is typically at the apex of the heart or the lower left sternal border. This requires the nurse to analyze the patient's symptoms and apply knowledge of cardiac anatomy to determine the optimal auscultation site.

A: Multiple-response item, comprehension level - This choice involves selecting multiple correct answers from a list of options based on understanding the presented information. It doesn't require the critical thinking and analysis needed in this scenario.

C: Chart/exhibit item, application level - This choice involves interpreting information presented in a chart or exhibit to apply it to a specific situation. While it involves application, it doesn't require the same level of analysis as determining the best auscultation site.

D: Drag-and

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A nursing student scores 95% on the written examination for the adult health course. To be successful in this course, this same student must then perform an indwelling catheter insertion and wound care in a simulated environment meeting core competencies. The student asks, "What are core competencies?" The nursing instructor replies, "Core competencies are:

  • A. a trend used in nursing education to reduce attrition in prelicensure students."
  • B. those skills necessary for safe, competent nursing practice."
  • C. educational opportunities that provide remediation when student is unable to perform psychomotor skills correctly."
  • D. critical thinking exercises aimed to improve reading and math skills."
Correct Answer: B

Rationale: The correct answer is B: those skills necessary for safe, competent nursing practice. Core competencies refer to the essential skills and knowledge required for safe and competent nursing practice. In the scenario provided, the nursing student needs to demonstrate proficiency in indwelling catheter insertion and wound care to meet these core competencies. These skills are crucial for providing quality patient care and ensuring patient safety.

Choice A is incorrect because core competencies are not about reducing attrition but rather about ensuring students possess the necessary skills for nursing practice. Choice C is incorrect as core competencies focus on skills required for practice, not on educational remediation. Choice D is incorrect because core competencies are not about improving reading and math skills but about the specific nursing skills needed for practice.

Qualified nursing school applicants have continued to be turned away, limiting enrollment due to a shortage of faculty, which is attributed to several factors, including:

  • A. nursing faculty are subject to high levels of burnout and job dissatisfaction.
  • B. only the number of faculty in Associate Degree programs remain stable.
  • C. the mean age of nursing faculty continues to decrease and older faculty mentors have left the profession.
  • D. increasing job competition from higher paying clinical sites, even as the economy recovers.
Correct Answer: A

Rationale: The correct answer is A because it directly addresses the shortage of nursing faculty by highlighting the issue of burnout and job dissatisfaction, which leads to faculty turnover and limits enrollment. This explanation aligns with the initial statement that qualified applicants are being turned away due to the shortage of faculty.

Choices B, C, and D are incorrect because they do not directly address the main issue of faculty shortage. B talks about the stability of faculty numbers in Associate Degree programs, which is irrelevant to the shortage. C discusses the decrease in the mean age of nursing faculty and the departure of older mentors, but this does not explain the shortage of faculty. D mentions increasing job competition from clinical sites, which is not the primary reason for the shortage of nursing faculty.

A nurse interested in quality improvement tools performed a search for cause and effect diagrams using www.ishikawa.com. A page opened that provided images and templates for performing fishbone diagrams. Which type of search did the nurse conduct?

  • A. Quick and dirty
  • B. Advanced
  • C. Brute force
  • D. Link searching
Correct Answer: B

Rationale: The correct answer is B: Advanced. The nurse conducted an advanced search by specifically looking for cause and effect diagrams on a website dedicated to providing images and templates for fishbone diagrams. This demonstrates a targeted and refined search strategy, indicating a higher level of proficiency in using search tools. The other choices are incorrect because: A) Quick and dirty implies a hasty and superficial search, which was not the case here. C) Brute force suggests an exhaustive and unrefined search method, which was not demonstrated in this scenario. D) Link searching involves following hyperlinks to find information, which was not explicitly stated in the question.

to that provided during the Crimean War?

  • A. Epidemics such as smallpox and typhoid were the primary emphasis of nursing care in both wars.
  • B. Soldiers were housed in substandard conditions, but due to Nightingale's push for sanitary conditions, in the Civil War soldiers were housed in aseptic conditions.
  • C. Black nurses were widely accepted by society and the profession, receiving equal compensation during the Civil War due in large part to the efforts of Mary Seacole during the Crimean War.
  • D. Both Nightingale (Crimean War) and Dix (Civil War) completed nursing training before accepting positions as nurses in the wars.
Correct Answer: B

Rationale: The correct answer is B because it accurately reflects the impact of Florence Nightingale's efforts during the Crimean War on nursing care during the Civil War. Nightingale advocated for sanitary conditions which led to improved housing for soldiers in the Civil War. This is supported by historical evidence.

A is incorrect because the emphasis on nursing care differed between the wars, with the Crimean War focusing more on basic care and the Civil War emphasizing sanitary conditions.

C is incorrect because black nurses faced discrimination and unequal compensation during both wars, and Mary Seacole's contributions were not widely recognized during the Civil War.

D is incorrect because Nightingale did not complete formal nursing training before her work in the Crimean War, and Dix was already an experienced nurse before the Civil War.

During a health history interview, the nurse listens to a patient relating the precipitating events that led to the onset of chest pain. She focuses her attention on the patient, makes eye contact, and acknowledges what the patient has to say. The nurse is exhibiting:

  • A. assertive communication.
  • B. active listening.
  • C. empathy.
  • D. passive communication.
Correct Answer: B

Rationale: The correct answer is B: active listening. Active listening involves fully focusing on the speaker, making eye contact, acknowledging what they are saying, and showing genuine interest in their words. In this scenario, the nurse is attentively listening to the patient's account of the events leading to chest pain, demonstrating active listening skills by being present in the moment and engaging with the patient's narrative.

A: Assertive communication involves expressing one's thoughts and feelings clearly and respectfully. This choice is incorrect because the nurse is not actively expressing her thoughts or feelings in this situation.

C: Empathy involves understanding and sharing the feelings of another. While empathy is important in nursing care, the nurse in this scenario is primarily engaged in listening rather than specifically expressing empathy.

D: Passive communication is characterized by a lack of assertiveness and active engagement in the conversation. This choice is incorrect because the nurse is actively listening and engaging with the patient's narrative.

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