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An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?
- A. One or more of the parties may be able to reconcile their values.
- B. The patient’s point of view is recognized as valuable.
- C. The dilemma involves two or more equally unpleasant choices.
- D. The institution is unable to honor the patient’s request.
Correct Answer: D
Rationale: The correct answer is D because if the institution is unable to honor the patient's request, it can create a barrier to reaching an agreement in an ethical dilemma. If the institution cannot support the patient's wishes, it can lead to conflicting viewpoints and hinder consensus. In contrast, choices A, B, and C do not directly address the institutional aspect and are not as relevant to the primary reason for the inability to reach an agreement in this context. Choice A focuses on individual values, choice B emphasizes the patient's perspective, and choice C pertains to the nature of the dilemma itself rather than external factors like institutional limitations.
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Which of the following types of leadership behaviors would be most useful when managing a staff of newly trained CNAs (Certified Nursing Assistants)?
- A. Achievement-oriented
- B. Supportive
- C. Participative
- D. Directive
Correct Answer: D
Rationale: The correct answer is D: Directive. In managing newly trained CNAs, directive leadership is most useful as it provides clear instructions and guidance for the inexperienced staff. This helps ensure they understand expectations and tasks. Achievement-oriented leadership (A) may be overwhelming for new staff, supportive leadership (B) may not provide enough structure, and participative leadership (C) may be confusing for staff who require clear direction and guidance. Ultimately, directive leadership is the most appropriate for managing newly trained CNAs due to the need for clear instructions and structure.
Which of the following best describes the role of a nurse navigator?
- A. Provide direct patient care
- B. Coordinate complex care
- C. Assist with administrative tasks
- D. Manage clinical trials
Correct Answer: B
Rationale: The correct answer is B because a nurse navigator's role is to coordinate complex care for patients by guiding them through the healthcare system, connecting them with resources, and ensuring continuity of care. Providing direct patient care (A) is typically the responsibility of nurses, not nurse navigators. Assisting with administrative tasks (C) is more aligned with roles such as medical assistants or administrative staff. Managing clinical trials (D) involves research and regulatory responsibilities that are distinct from the care coordination focus of a nurse navigator. Therefore, the best description of a nurse navigator's role is coordinating complex care.
Which theory views motivation as learning?
- A. Reinforcement
- B. Process
- C. Operant
- D. Conditioning
Correct Answer: A
Rationale: The correct answer is A: Reinforcement. Reinforcement theory views motivation as learning through the use of positive or negative reinforcement to increase the likelihood of a behavior being repeated. By associating certain behaviors with rewards or punishments, individuals learn to be motivated to engage in those behaviors. The other choices, B: Process, C: Operant, and D: Conditioning, are incorrect because they do not specifically focus on motivation as a learned behavior through reinforcement. Process theory emphasizes cognitive processes, Operant theory focuses on shaping behavior through consequences, and Conditioning theory is a general term for learning through associations.
The nurse determines a need for additional instruction when the patient with newly diagnosed
type 1 diabetes says which of the following?
- A. “I can have an occasional alcoholic drink if I include it in my meal plan.”
- B. “I will need a bedtime snack because I take an evening dose of NPH insulin.”
- C. “I can choose any foods, as long as I use enough insulin to cover the calories.”
- D. “I will eat something at meal times to prevent hypoglycemia, even if I am not hungry.”
Correct Answer: C
Rationale: The correct answer is C because stating "I can choose any foods, as long as I use enough insulin to cover the calories" shows a lack of understanding of diabetes management. In type 1 diabetes, it's crucial to follow a balanced diet to regulate blood sugar levels. Choosing any foods without considering their impact on blood sugar control can lead to unstable glucose levels.
Explanation for why the other choices are incorrect:
A: Choosing to have an occasional alcoholic drink if included in the meal plan is acceptable as long as it's done in moderation and accounted for in the overall diabetes management plan.
B: Needing a bedtime snack with NPH insulin is appropriate to prevent hypoglycemia overnight.
D: Eating something at meal times to prevent hypoglycemia, even if not hungry, is a good practice to maintain stable blood sugar levels.
The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose
- A. washes the puncture site using warm water and soap
- B. chooses a puncture site in the center of the finger pad
- C. hangs the arm down for a minute before puncturing the site
- D. says the result of 120 mg indicates good blood sugar control
Correct Answer: B
Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad can lead to increased pain and potential nerve damage. Washing the puncture site with warm water and soap (A) is important for hygiene. Hanging the arm down before puncturing (C) can help with blood flow. Interpreting a blood sugar level of 120 mg as good control (D) is incorrect as it is above the normal range. By selecting the center of the finger pad, the patient risks causing unnecessary pain and nerve damage.