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An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision-makers involved. Which step best describes the current stage the RN is working through?
- A. Assessment
- B. Diagnosis
- C. Planning
- D. Implementation
Correct Answer: C
Rationale: The correct answer is C: Planning. In an ethical dilemma, once the decision-makers are identified, the next step is to plan the course of action to address the issue. Planning involves considering the ethical principles, potential outcomes, and identifying the best course of action to resolve the dilemma. Assessment (A) involves gathering information, Diagnosis (B) involves analyzing the information, and Implementation (D) involves executing the chosen plan. Therefore, the RN is currently in the planning stage as he is strategizing on how to address the ethical dilemma effectively.
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Which question during the assessment of a diabetic patient will help the nurse identify
autonomic neuropathy?
- A. “Do you feel bloated after eating?”
- B. “Have you seen any skin changes?”
- C. “Do you need to increase your insulin dosage when you are stressed?”
- D. “Have you noticed any painful new ulcerations or sores on your feet?”
Correct Answer: A
Rationale: Rationale: Autonomic neuropathy affects digestion, leading to bloating after eating. This symptom is related to the dysfunction of the autonomic nervous system. Skin changes, insulin dosage changes due to stress, and new ulcerations are not specific to autonomic neuropathy. Bloated feeling after eating is a classic symptom of autonomic neuropathy due to impaired gastrointestinal motility.
A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?
- A. Lispro (Humalog)
- B. Glargine (Lantus)
- C. Detemir (Levemir)
- D. NPH (Humulin N)
Correct Answer: A
Rationale: The correct answer is A: Lispro (Humalog). Lispro is a rapid-acting insulin that is ideal for mealtime coverage in intensive insulin therapy because it mimics the body's natural insulin response after a meal, providing quick and effective blood sugar control. Lispro has a rapid onset of action, peaks quickly, and has a shorter duration of action compared to other types of insulin. This makes it suitable for covering the rise in blood sugar levels that occurs after meals.
Summary of why other choices are incorrect:
B: Glargine (Lantus) is a long-acting insulin used for basal coverage, not for mealtime coverage.
C: Detemir (Levemir) is an intermediate-acting insulin used for basal coverage, not for mealtime coverage.
D: NPH (Humulin N) is an intermediate-acting insulin with a slower onset and longer duration of action, making it less suitable for mealtime coverage in intensive insulin therapy.
A registered nurse (RN) administered a patient’s morning insulin as the breakfast tray arrived at 0800. The RN performed a complete assessment at the same time. Then, the RN got busy with her other patients and did not check on the patient until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. Which of the following could the RN be charged with?
- A. Quasi-intentional tort
- B. Misdemeanor
- C. Negligence
- D. Juvenile offense
Correct Answer: C
Rationale: The correct answer is C: Negligence. The RN failed to monitor the patient after administering insulin, leading to a critical situation. Negligence in nursing involves a breach of duty of care that results in harm to the patient. In this case, the RN's failure to check on the patient for several hours directly contributed to the patient becoming unresponsive with dangerously low blood glucose levels. This constitutes a clear case of nursing negligence.
A: Quasi-intentional tort involves intentional actions that result in harm, such as defamation or invasion of privacy. This scenario does not involve intentional harm.
B: Misdemeanor refers to a criminal offense less serious than a felony. Negligence in nursing is typically addressed through civil, not criminal, proceedings.
D: Juvenile offense pertains to actions committed by minors. The RN is a healthcare professional, not a minor, and the offense here is related to professional negligence, not juvenile misconduct.
What is the primary focus of the Triple Aim in healthcare?
- A. Improving patient experience
- B. Reducing healthcare costs
- C. Improving population health
- D. Ensuring regulatory compliance
Correct Answer: A
Rationale: The primary focus of the Triple Aim in healthcare is to improve patient experience, which encompasses quality, safety, and satisfaction. This approach aims to enhance care delivery, promote patient-centeredness, and optimize outcomes. Reducing healthcare costs and improving population health are important aspects but are secondary to enhancing the patient experience. Ensuring regulatory compliance is crucial but not the primary objective of the Triple Aim framework. Thus, choice A is correct as it aligns with the core principle of prioritizing the needs and preferences of patients for better overall healthcare outcomes.
A supervisor is restricting the flow of communication between staff. This has resulted in the staff having two very opposite directions. The supervisor's actions are known as which type of force?
- A. Opposing force
- B. Driving force
- C. Restraining force
- D. Restrictive force
Correct Answer: C
Rationale: The correct answer is C: Restraining force. In this scenario, the supervisor's actions of restricting communication act as a restraining force, hindering the flow of information and causing conflicting directions among the staff. A restraining force limits the ability of individuals or groups to achieve their goals by imposing obstacles or constraints. Opposing force (A) implies a force in direct opposition, which is not the case here. Driving force (B) typically motivates action rather than restricts it. Restrictive force (D) is similar to restraining force but lacks the specific connotation of limiting communication in this context.