Ethics & Issues in Contemporary Nursing

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A physician complains to administration that the nurse working last evening is unethical, based on observing the nurse educate the patient about a new medication ordered. The physician demanded the nurse be reprimanded and reminded that only physicians have the educational background to teach patients about new medications. Which comment and action by the administrator would be most effective in changing nurse-physician relationships in this instance?

  • A. Inform the nurse, "You will be suspended for 3 days for going beyond your job description," and enforce the 3-day suspension because the physician did not write the order to "teach the patient about the new medication"
  • B. Advise the physician that only nurses can teach patients about medications; the physician's role is to only prescribe. No action will be taken against the nurse.
  • C. After investigating the situation, thank the physician while also providing information that patient education related to medication is within the scope of practice of registered nurses. Share the physician's concern and administrator's response with the nurse so both parties are aware of the resolution of the concerns.
  • D. Contact the patient's family and ask, "Do you prefer that all teaching related to medications be performed by the physician rather than the nurse" to determine what action to take.
Correct Answer: C

Rationale: Step 1: The administrator acknowledges the physician's concern to maintain a professional relationship.
Step 2: The administrator educates the physician that patient education on medications falls within the nurse's scope of practice.
Step 3: The administrator addresses the nurse and physician to ensure both are informed of the resolution.
Step 4: This approach promotes mutual understanding and respect between nurse and physician.
Summary: Option C is the correct answer as it acknowledges the physician's concern, educates on scope of practice, and fosters communication between both parties. Options A, B, and D are incorrect as they either punish the nurse unjustly, fail to educate the physician, or involve unrelated parties in the decision-making process.

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A nurse responsible for staffing a medical-surgical unit must consider: (select all that apply)

  • A. the patient census.
  • B. physical layout of the unit.
  • C. complexity of care required.
  • D. educational level of all staff.
Correct Answer: A

Rationale: The correct answer is A: the patient census. This is crucial for determining the appropriate number of staff needed to provide safe and effective care based on the current number of patients. The patient census directly impacts workload and patient acuity levels. Choices B, C, and D are incorrect because although they may be important factors to consider when staffing a medical-surgical unit, they are not as directly related to determining the immediate staffing needs based on the current patient load. The physical layout of the unit, complexity of care required, and educational level of staff are important for overall unit operations and quality of care but do not have the same immediate impact on staffing decisions as the patient census.

When the job applicant is asked to identify weaknesses, one appropriate reply for the novice nurse might be:

  • A. "I have no weaknesses."
  • B. "Are you trying to set me up?"
  • C. "Delegating to peers."
  • D. "Caring requires weakness."
Correct Answer: C

Rationale: The correct answer is C: "Delegating to peers." This response shows self-awareness and willingness to improve by acknowledging a common weakness for novice nurses - difficulty in delegating tasks to peers. It demonstrates a willingness to learn and grow in the role.

A: "I have no weaknesses." - This answer lacks self-awareness and does not show a willingness to improve. It comes across as overconfident.
B: "Are you trying to set me up?" - This response is defensive and unprofessional. It does not address the question directly.
D: "Caring requires weakness." - This answer is vague and does not provide a specific weakness or show a proactive approach to self-improvement.

During the relief response phase of a disaster resulting from a "dirty bomb":

  • A. treatment for burns and poisoning is provided for victims.
  • B. emergency plans are coordinated between agencies.
  • C. reconstruction of destroyed facilities and homes begins.
  • D. food stores are collected for potential victims.
Correct Answer: A

Rationale: The correct answer is A because during the relief response phase of a "dirty bomb" disaster, victims are likely to suffer from burns and poisoning due to radiation exposure. Providing treatment for burns and poisoning is crucial to saving lives and preventing further health complications.

Choice B is incorrect because emergency plans coordination typically occurs during the preparedness phase, not the relief response phase. Choice C is incorrect as reconstruction usually takes place in the recovery phase, which follows the relief response phase. Choice D is incorrect as collecting food stores is more related to preparedness or immediate response, not specifically during the relief response phase.

A patient observes the practitioner burning a dried herb on the needle during an acupuncture session and asks about this practice. The practitioner responds, "I am inciting the acupuncture points and this is referred to as:

  • A. doshas."
  • B. moxibustion."
  • C. yoga."
  • D. kapha."
Correct Answer: B

Rationale: The correct answer is B: moxibustion. Moxibustion is a traditional Chinese medicine technique that involves burning dried herbs on or near acupuncture points to stimulate them. This practice helps to improve the flow of Qi and promote healing. Doshas (choice A) and kapha (choice D) are terms from Ayurveda, not related to acupuncture. Yoga (choice C) is a separate practice that involves physical postures and breathing exercises, not burning herbs on acupuncture points.

The use of research to guide nursing practice is called:

  • A. utilization.
  • B. dissemination.
  • C. generalizability.
  • D. analysis.
Correct Answer: A

Rationale: The correct answer is A: utilization. Research utilization refers to the application of research findings in nursing practice to improve patient outcomes. Utilization involves integrating research evidence into clinical decision-making. Dissemination (B) refers to sharing research findings. Generalizability (C) pertains to the extent to which research findings can be applied to different populations or settings. Analysis (D) involves examining data to draw conclusions, but it does not specifically relate to using research in practice like utilization does.

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