Ethics and Issues in Contemporary Nursing

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As part of a quality assurance project, a nurse is to round on every patient daily for 1 month to ensure the intravenous tubing is labeled with date hung and nurse's initials. The nurse is hoping to be promoted to a full-time position within the quality department, and her success on this project is very important to her receiving the position. The nurse retains all other assignments, and she is often interrupted to help other staff or answer call lights. The nurse discusses her concerns with the manager, who frees her for 1 hour each day to make rounds. During this 1 hour each day the nurse will organize herself and environment by practicing the:

  • A. art of "no detourism."
  • B. reducing stacked-desk syndrome.
  • C. art of "wastebasketry."
  • D. managing e-mail and memo mania.
Correct Answer: B

Rationale: The correct answer is B: reducing stacked-desk syndrome. This term refers to the practice of organizing tasks and environment to prevent work from piling up. In this scenario, the nurse is given 1 hour each day to focus solely on the quality assurance project, helping her prevent tasks from accumulating and ensuring she can complete her rounds efficiently. This practice enhances productivity and enables the nurse to manage her workload effectively.

Choice A, "art of 'no detourism,'" is irrelevant in this context as it does not address the issue of organizing tasks and environment. Choice C, "art of 'wastebasketry,'" is not applicable as it pertains to the skill of decision-making and prioritization, which is not the primary concern in this scenario. Choice D, "managing e-mail and memo mania," is also not directly related to the nurse's need to organize herself and environment for the quality assurance project.

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A patient is admitted for a hip replacement complicated by uncontrolled diabetes and early dementiThe nurse coordinates referrals to an endocrinologist to establish an insulin protocol and organizes out-patient physical therapy in an Alzheimer's assisted living facility upon discharge. The role of this nurse is the:

  • A. informatics specialist.
  • B. educator.
  • C. case manager.
  • D. quality manager.
Correct Answer: C

Rationale: Step-by-step rationale for why choice C (case manager) is correct:
1. A case manager coordinates referrals and services for patients with complex needs, such as this patient with diabetes and dementia.
2. In this scenario, the nurse is coordinating referrals to an endocrinologist and organizing physical therapy, which aligns with the role of a case manager.
3. Case managers ensure continuity of care and facilitate communication between different healthcare providers.
4. The nurse's role in organizing follow-up care and services for the patient falls under the responsibilities of a case manager.

Summary of why other choices are incorrect:
A: Informatics specialist - This role focuses on managing health information systems, not coordinating referrals and services for patients.
B: Educator - While education may be a component of the nurse's role, the primary focus in this scenario is on coordinating referrals and services, which is more in line with a case manager's responsibilities.
D: Quality manager - Quality managers focus on ensuring healthcare services meet quality standards

The novice nurse calls a supervisor and requests that a "float nurse" be assigned to help with all "assessments of new admissions and postoperative patients." The supervisor asks, "How many admissions and surgery patients have you received?" The novice nurse becomes flustered because she has not checked the census but simply bases the need on feeling overwhelmed. This situation best indicates a lack of skills.

  • A. organizational
  • B. communication
  • C. interpersonal
  • D. clinical
Correct Answer: A

Rationale: The correct answer is A: organizational skills. The novice nurse's inability to assess the number of admissions and postoperative patients before requesting assistance indicates a lack of organizational skills. Organizational skills involve prioritizing tasks, managing time efficiently, and planning ahead. In this scenario, the nurse failed to gather essential information before making a decision, leading to inefficiency and potential misallocation of resources.

Choice B: communication skills, is not the best answer because the issue is not primarily related to communication breakdown but rather a lack of organizational skills. Choice C: interpersonal skills, is not the best answer because the problem does not stem from the nurse's ability to interact with others but rather from her inability to organize her workload effectively. Choice D: clinical skills, is not the best answer because the situation is more about managing workload and resources rather than clinical knowledge or expertise.

A nurse plans to move to an area that is rich in immigrants from several countries and is concerned about respecting others' cultural beliefs. The nurse's first step to ensure cultural competence and sensitivity is to:

  • A. enroll in a nursing theories course to increase knowledge about transcultural practices.
  • B. become immersed in nursing literature about culturally diverse clients.
  • C. participate in continuing education that focuses on health assessment variations among cultural groups.
  • D. conduct a cultural self-assessment.
Correct Answer: D

Rationale: The correct answer is D: conduct a cultural self-assessment. This is the first step to ensure cultural competence because it allows the nurse to reflect on their own beliefs, biases, and cultural background, which can impact interactions with culturally diverse clients. By understanding one's own cultural identity, the nurse can better appreciate and respect the beliefs of others.

Choice A is incorrect because enrolling in a nursing theories course may provide knowledge but does not address the nurse's own biases. Choice B is also incorrect as immersion in nursing literature may increase knowledge but does not promote self-awareness. Choice C is incorrect as focusing on health assessment variations does not necessarily address cultural sensitivity in interactions. Conducting a cultural self-assessment is essential for building a foundation of cultural competence and respect.

A patient states, "My cancer is in remission finally after all that chemotherapy, my friend used the same chemotherapy and wasn't so lucky. I want to continue participating in spiritual care and 'mind games' to keep my memory intact. I am also enrolled in Tai chi, but I just can't stop thinking about my sick lung." This patient adheres to which principle underlying alternative healing?

  • A. A negative alteration in the body produces a parallel effect on the mind and spirit.
  • B. The body can heal itself with the help of complementary alternative therapies.
  • C. Approaches to therapy are individualized.
  • D. There is a focus on the total lifestyle.
Correct Answer: B

Rationale: Step-by-step rationale for why choice B is correct:
1. The patient believes in the power of complementary alternative therapies to help the body heal itself.
2. This aligns with the principle underlying alternative healing, which emphasizes the body's innate ability to heal.
3. By engaging in spiritual care, mind games, Tai chi, and focusing on memory and lung health, the patient is supporting the body's natural healing processes.
4. This choice is correct as it reflects the patient's belief in utilizing alternative therapies to support the body's healing mechanisms.

Summary of why other choices are incorrect:
A. This choice suggests a negative alteration affecting the mind and spirit, which is not directly related to the patient's belief in complementary alternative therapies for healing.
C. While individualized approaches to therapy are important in alternative healing, this choice does not directly address the patient's belief in the body's ability to heal itself.
D. While focusing on total lifestyle is important in alternative healing, this choice does not directly

Complementary alternative medicine (CAM) is gaining popularity in Western society because: (select all that apply)

  • A. consumers want knowledgeable, trained physicians to control their care.
  • B. CAM consumers want personalized health care.
  • C. quantity, rather than quality, of life is most important in Western society.
  • D. consumers have access to evidence that support CAMs.
Correct Answer: B

Rationale: The correct answer is B: CAM consumers want personalized health care. This is because CAM focuses on holistic and individualized approaches to health, addressing not just symptoms but underlying causes. Consumers seek CAM for tailored treatments and a more patient-centered approach.

Choice A is incorrect because CAM often involves practitioners who may not be traditional physicians. Choice C is incorrect as quality of life, rather than just quantity, is increasingly valued in Western society. Choice D is incorrect because although there is some evidence supporting CAM, it is not always readily accessible or universally accepted.

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