Nokea
An elderly patient is admitted to your unit with a diagnosis of community-acquired pneumonia. During admission the patient states, I have a living will. What implication of this should the nurse recognize?
- A. This document is always honored, regardless of circumstances.
- B. This document specifies the patients wishes before hospitalization.
- C. This document that is binding for the duration of the patients life.
- D. This document has been drawn up by the patients family to determine DNR status.
Correct Answer: B
Rationale: A living will is one type of advance directive. In most situations, living wills are limited to situations in which the patients medical condition is deemed terminal. The other answers are incorrect because living wills are not always honored, they are not binding for the duration of the patients life, and they are not drawn up by the patients family.
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A nurse has been providing ethical care for many years and is aware of the need to maintain the ethical principle of nonmaleficence. Which of the following actions would be considered a contradiction of this principle?
- A. Discussing a DNR order with a terminally ill patient
- B. Assisting a semi-independent patient with ADLs
- C. Refusing to administer pain medication as ordered
- D. Providing more care for one patient than for another
Correct Answer: C
Rationale: The duty not to inflict as well as prevent and remove harm is termed nonmaleficence. Discussing a DNR order with a terminally ill patient and assisting a patient with ADLs would not be considered contradictions to the nurses duty of nonmaleficence. Some patients justifiably require more care than others.
A nurse uses critical thinking every day when going through the nursing process. Which of the following is an outcome of critical thinking in nursing practice?
- A. A comprehensive plan of care with a high potential for success
- B. Identification of the nurses preferred goals for the patient
- C. A collaborative basis for assigning care
- D. Increased cost efficiency in health care
Correct Answer: A
Rationale: Critical thinking in nursing practice results in a comprehensive plan of care with maximized potential for success. Critical thinking does not identify the nurses goal for the patient or provide a collaborative basis for assigning care. Critical thinking may or may not lead to increased cost efficiency; the patients outcomes are paramount.
Critical thinking and decision-making skills are essential parts of nursing in all venues. What are examples of the use of critical thinking in the venue of genetics-related nursing?
- A. Notifying individuals and family members of the results of genetic testing
- B. Providing a written report on genetic testing to an insurance company
- C. Assessing and analyzing family history data for genetic risk factors
- D. Identifying individuals and families in need of referral for genetic testing
- E. Ensuring privacy and confidentiality of genetic information
Correct Answer: C,D,E
Rationale: Nurses use critical thinking and decision-making skills in providing genetics-related nursing care when they assess and analyze family history data for genetic risk factors, identify those individuals and families in need of referral for genetic testing or counseling, and ensure the privacy and confidentiality of genetic information. Nurses who work in the venue of genetics-related nursing do not notify family members of the results of an individuals genetic testing, and they do not provide written reports to insurance companies concerning the results of genetic testing.
A nurse has been using the nursing process as a framework for planning and providing patient care. What action would the nurse do during the evaluation phase of the nursing process?
- A. Have a patient provide input on the quality of care received.
- B. Remove a patients surgical staples on the scheduled postoperative day.
- C. Provide information on a follow-up appointment for a postoperative patient.
- D. Document a patients improved air entry with incentive spirometric use.
Correct Answer: D
Rationale: During the evaluation phase of the nursing process, the nurse determines the patients response to nursing interventions. An example of this is when the nurse documents whether the patients spirometry use has improved his or her condition. A patient does not do the evaluation. Removing staples and providing information on follow-up appointments are interventions, not evaluations.
A nurse is admitting a new patient to the medical unit. During the initial nursing assessment, the nurse has asked many supplementary open-ended questions while gathering information about the new patient. What is the nurse achieving through this approach?
- A. Interpreting what the patient has said
- B. Evaluating what the patient has said
- C. Assessing what the patient has said
- D. Validating what the patient has said
Correct Answer: D
Rationale: Critical thinkers validate the information presented to make sure that it is accurate (not just supposition or opinion), that it makes sense, and that it is based on fact and evidence. The nurse is not interpreting, evaluating, or assessing the information the patient has given.