Ethics & Issues in Contemporary Nursing

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A student nurse assigned to work with the charge nurse is given the opportunity to help revise the nursing assessment form. She receives several compliments from management and her nursing instructor for her creative suggestions. The student nurse enjoys the project and attention she is receiving and begins to prolong the conclusion of the project. Although she constantly adds new information, she filters this out slowly to others. The student nurse is subject to the time management obstacle of:

  • A. need for perfection.
  • B. fear of losing creativity.
  • C. unclear goals.
  • D. fear of completion.
Correct Answer: D

Rationale: The correct answer is D: fear of completion. This is because the student nurse is prolonging the conclusion of the project despite constantly adding new information and filtering it out slowly to others. This behavior indicates a reluctance to finish the project, likely due to a fear of moving on to the next stage or fear of evaluation. The student nurse is enjoying the attention and positive feedback, leading to a delay in completing the task.

A: The need for perfection is not the primary obstacle in this scenario as the student nurse is not necessarily striving for perfection but rather avoiding completion.
B: Fear of losing creativity is not the main issue here as the student nurse is still adding new information, indicating creativity is not the concern.
C: Unclear goals do not seem to be the obstacle as the student nurse is actively engaged in the project and receiving positive feedback.

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A novice nurse notices a patient is pacing the floor and twisting his hands. When the nurse enters the room, the patient stares at her and mumbles, "Can't anyone understand what I want?" while smiling and reaching out to shake the nurse's hand. The nurse recognizes a risk for violence based on which clinical findings? (select all that apply)

  • A. Glaring at the nurse
  • B. Nervousness, twisting of hands
  • C. Murmuring when talking
  • D. Diagnosis of a terminal illness
Correct Answer: A

Rationale: The correct answer is A because glaring at the nurse indicates potential aggression and hostility, which are red flags for violence risk. Glaring can be a non-verbal sign of anger or frustration, signaling a potential escalation. In contrast, nervousness and twisting of hands (choice B) may indicate anxiety or distress but not necessarily violence. Murmuring when talking (choice C) may suggest communication difficulties but does not directly indicate violence risk. Lastly, a diagnosis of a terminal illness (choice D) is not directly related to the immediate risk of violence in this scenario.

A nurse is brought in who testifies that a professional with the knowledge and skill of an RN should understand that, before administering this drug, potassium level and pulse level is always checked to prevent such an occurrence. The nurse's testimony as to what constitutes reasonable care is based on:

  • A. the legal definition of standard of care.
  • B. the legal definition of the informed consent process.
  • C. the doctrine of res ipsa loquitur.
  • D. governmental immunity.
Correct Answer: A

Rationale: The correct answer is A: the legal definition of standard of care. In healthcare, the standard of care refers to the level of care that a reasonably prudent healthcare professional would provide in similar circumstances. Checking potassium level and pulse before administering a drug is considered standard practice to prevent adverse reactions. The nurse's testimony is based on this standard of care requirement to ensure patient safety and avoid potential harm. Choices B, C, and D are incorrect because they do not directly relate to the concept of standard of care in healthcare practice. B pertains to patient consent, C to the doctrine of "the thing speaks for itself," and D to immunity from liability for certain actions.

As a patient's condition moves toward their impending death, which nursing intervention demonstrates how the focus of palliative care change?

  • A. The patient is encouraged to discuss their spiritual needs.
  • B. The patient is educated concerning the physical changes associated with the dying process.
  • C. The patient's advance care plan is formulated and implemented.
  • D. The patient's comfort needs are identified.
Correct Answer: D

Rationale: The correct answer is D because as a patient approaches death, the focus of palliative care shifts towards providing comfort and symptom management to improve their quality of life. Identifying and addressing the patient's comfort needs becomes crucial in ensuring a peaceful and dignified end-of-life experience.

A: While discussing spiritual needs can be important, the primary focus shifts towards physical comfort in the final stages of life.
B: Educating the patient about physical changes is important, but it may not be the priority as the focus shifts towards comfort care.
C: Advance care planning is essential but may have already been addressed before the patient reaches the impending death stage.

In the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination test plan, client needs form the organizing framework of the examination with questions in four categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiologic integrity. Certain processes are then integrated throughout the categories of client needs. Which process is integrated into all client need categories?

  • A. Teaching/learning
  • B. Health promotion
  • C. Infection control
  • D. Pharmacology
Correct Answer: C

Rationale: 1. Infection control is crucial in ensuring safe and effective care for all clients.
2. Infection control measures are essential in preventing the spread of infections in healthcare settings.
3. Infection control is relevant in promoting and maintaining health by preventing illness.
4. Psychosocial integrity can be compromised by infections, making infection control important in this category.
5. Physiologic integrity involves preventing and managing infections through proper protocols.
6. While teaching/learning, health promotion, and pharmacology are important, they are not integrated into all client need categories like infection control.

A nurse is admitting a Mexican-American child, and the mother comments that the child was exposed to mal ojo. The nurse should expect to find which symptom associated with this exposure?

  • A. Fever
  • B. Nervous tension
  • C. Bruising
  • D. Somnolence
Correct Answer: B

Rationale: The correct answer is B: Nervous tension. Mal ojo, commonly known as the evil eye, is a belief in many Latin American cultures that certain people have the power to cause harm with their gaze. Symptoms associated with mal ojo typically include nervous tension, irritability, and restlessness. Fever (choice A) is not a common symptom of mal ojo. Bruising (choice C) is also not typically associated with mal ojo. Somnolence (choice D) refers to excessive sleepiness, which is not a common symptom of mal ojo. Therefore, the correct answer is B as it aligns with the cultural belief and expected symptoms of mal ojo.

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