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A woman presents with bruises on her face and back in various stages of healing. She states, 'sometimes he just gets so angry.' Which of the following statements is most appropriate as a response from the nurse?
- A. Do you mean your boyfriend?
- B. Do you mean your boyfriend?
- C. No one will ever hurt you again.
- D. Tell me more about what happens when he gets angry.
Correct Answer: D
Rationale: The correct answer is D: "Tell me more about what happens when he gets angry." This response is appropriate because it encourages the woman to share more information about the situation, allowing the nurse to assess the potential abuse and provide appropriate support. Choice A and B are identical and do not prompt further discussion. Choice C is dismissive and unrealistic. Asking for more details, as in choice D, helps gather crucial information for intervention.
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The nurse is assessing an infant with developmental dysplasia of the hip. Which finding would the nurse anticipate?
- A. Unequal leg length
- B. Limited adduction
- C. Diminished femoral pulses
- D. Symmetrical gluteal folds
Correct Answer: A
Rationale: The correct answer is A: Unequal leg length. In developmental dysplasia of the hip, there is abnormal development of the hip joint. This can lead to unequal leg lengths due to hip instability and dislocation. Limited adduction may be present due to hip joint abnormalities. Diminished femoral pulses are not typically associated with developmental dysplasia of the hip. Symmetrical gluteal folds are usually present in healthy infants.
Which example best describes a nurse who exhibits moral courage?
- A. A nurse feels angry when a parent refuses important treatment for his child.
- B. A nurse considers seeking help for depression when she feels she cannot meet the needs of her clients in the oncology unit.
- C. A nurse contacts a physician for further orders when he fails to order comfort measures for a client with a terminal illness.
- D. A nurse is frustrated when the laboratory is slow in responding to an order for a stat blood glucose.
Correct Answer: C
Rationale: The correct answer is C because it demonstrates moral courage by advocating for the client's well-being in the face of potential conflict with the physician. By taking action to ensure the comfort of a terminally ill client, the nurse upholds ethical principles. Choice A reflects emotional response, not moral courage. Choice B focuses on personal issues, not professional courage. Choice D involves frustration, not moral courage.
A nurse is required to float to another unit within the hospital where he is asked to care for a client on a ventilator. The nurse is uncomfortable with this assignment, as he has not had a ventilated client since nursing school. What is the nurse's most appropriate response?
- A. Explain to the nursing supervisor the level of discomfort and ask for a different assignment
- B. State that the client's needs are outside the nurse's scope of practice and request a different assignment
- C. Accept the assignment, asking for help when necessary
- D. Request to return to the home unit and send another nurse who can perform the job
Correct Answer: A
Rationale: The correct answer is A: Explain to the nursing supervisor the level of discomfort and ask for a different assignment. This is the most appropriate response because the nurse is being transparent about their discomfort and seeking a solution to ensure quality care for the client. By communicating concerns, the nurse can potentially be given a more suitable assignment or receive additional training. Option B is incorrect as it is important for nurses to continuously learn and adapt to new situations within their scope of practice. Option C is not ideal as the nurse should not take on a task they are uncomfortable with without proper support. Option D is not the best choice as it does not address the issue directly with the supervisor.
Which example best describes the concept of beneficence?
- A. A nurse provides pain medication for a client in the recovery room who is experiencing pain
- B. A client has an advanced directive in place stating that he does not want intubation if he needs CPR
- C. At the request of the client, a nurse does not inform the family about his cancer diagnosis
- D. A nurse withholds narcotic medication for a client in pain, knowing that he is currently disoriented
Correct Answer: A
Rationale: The correct answer is A because beneficence refers to the ethical principle of doing good and promoting the well-being of the patient. Providing pain medication to a client in the recovery room aligns with this principle as it aims to alleviate suffering and improve the client's comfort. This action demonstrates a commitment to the client's best interests and upholds the duty of care.
Choice B is incorrect because it relates to autonomy, where the client's wishes regarding medical treatment are respected. Choice C is incorrect as it violates the principle of veracity by withholding important information from the family. Choice D is incorrect as it goes against beneficence by not addressing the client's pain adequately.
A nurse is caring for a dying client whose family wants to be with him in the operating suite. The surgeon, however, does not allow families to be present during surgery. The nurse recognizes this as an ethical dilemma. What is the initial step of the nurse when managing this situation?
- A. Contact the physician to amend the order for the client
- B. Document an account of the situation to ensure adequate coverage of details
- C. Consult with the medical ethics committee to determine a safe and workable solution
- D. Speak with the chief nursing officer to change the policy governing this situation
Correct Answer: A
Rationale: The correct initial step is to choose option A: Contact the physician to amend the order for the client. This is the most appropriate action because the conflict arises from the surgeon's policy, which can potentially be changed with physician involvement. By discussing the situation with the physician, the nurse can advocate for the family's wishes and potentially negotiate a compromise. This step prioritizes the client's and family's needs while also respecting the surgeon's authority. Options B, C, and D are not the initial steps because they involve escalating the situation before attempting direct communication with the physician, which can be seen as bypassing the appropriate chain of command.