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Based on the information provided, what can be inferred about the nurse who has been working for several years in a long-term care facility with many Middle Eastern residents?
- A. The nurse's knowledge and skills provide expected care for clients in this demographic.
- B. The nurse is knowledgeable about Middle Eastern culture and respects and values providing culturally competent care.
- C. The nurse is attempting to overcompensate for cultural blindness and ethnocentrism within the community.
- D. This employment has allowed the nurse to demonstrate ethnic identity and cultural bias to a specific group of people.
Correct Answer: B
Rationale: The nurse in the scenario is likely knowledgeable about Middle Eastern culture and values providing culturally competent care to the residents. This inference can be made based on the nurse being well-respected and effective in providing care to this population. Choice A is incorrect because it only focuses on the nurse's knowledge and skills, not specifically about cultural competence. Choice C is incorrect as there is no indication of overcompensation; the nurse is described as effective and well-respected. Choice D is incorrect as there is no evidence to suggest that the nurse is demonstrating ethnic identity or cultural bias, but rather respecting and providing care tailored to the cultural needs of the residents.
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A discharge planning nurse works with a wide variety of families when organizing care for older adults after their discharge from the hospital. Which of the following relationship structures would the nurse consider to be a family? Select all that apply.
- A. Mr. E and his partner, Mr. S, who live together in an apartment
- B. Mr. R and his new 'lady friend,' who began cohabiting 2 months ago
- C. Mrs. B and her daughter, son-in-law, and widowed sister, all of whom share a house
- D. Mr. R, who is estranged from his children and has lived with his brother, a bachelor, for several years
Correct Answer: A
Rationale: The correct answer is A. While not traditional nuclear family structures, all of the given relationships and living arrangements constitute family units. Mr. E and his partner, Mr. S, who live together in an apartment, form a family unit. Choice B is not considered a family as it describes a relatively new and non-committal relationship. Choice C describes a traditional family structure with Mrs. B, her daughter, son-in-law, and widowed sister sharing a house, which also constitutes a family unit. Choice D describes a situation where Mr. R is estranged from his children and living with his bachelor brother, which can also be considered a family unit but is not as inclusive as the relationship described in choice A.
To minimize liability, what action should nurses take when accepting telephone orders from physicians?
- A. Ask the physician to follow up with a faxed, written order
- B. Clearly communicate the most likely diagnosis to the physician
- C. Have another staff member talk with the physician and audiotape the conversation
- D. Accept only written orders or those communicated orally, in person
Correct Answer: A
Rationale: The best action for nurses to take when accepting telephone orders from physicians to minimize liability is to ask the physician to follow up with a faxed, written order and ensure it is signed within 24 hours. This approach helps ensure clarity, accuracy, and documentation of the physician's orders, reducing the risk of misinterpretation or errors. Choices B, C, and D are incorrect. Communicating a diagnosis is outside the nurse's scope of practice and should be done by the physician. Involving another staff member to audiotape the conversation can introduce legal and practical issues. Accepting only written or orally communicated orders in person may not always be practical or feasible in urgent situations where telephone orders are necessary.
A newly hired nurse is being orientated in a community health center that provides care to the adjacent large Native American reservation/Canadian aboriginal reserve. Which statement by the nurse indicates a sound understanding of the Native American/First Nations population?
- A. I suppose that we will see a disproportionately high number of clients with lung and oral cancers.
- B. The high prevalence of diabetes and hypertension mean that strokes are likely to be relatively frequent in the area.
- C. It is unfortunate that many of the older Native Americans/First Nations people are unlikely to have family members involved in their care.
- D. The unique skin pigmentation of Native Americans/First Nations people means that I will have to modify my assessment techniques.
Correct Answer: B
Rationale: Diabetes, hypertension, and stroke are all higher than average in Native American/First Nations adults. Lung and oral cancers are not noted to have a higher prevalence and family is likely to be involved in the care of these older adults. The skin tone of Native American/First Nations people is not noted to require specific assessment techniques. The Native American population may have close family bonds.
Which of the following is required in order for a healthcare provider to be legally justified in not attempting to save a client's life?
- A. A 'Do Not Resuscitate' (DNR) statement on the patient's care plan
- B. A 'No-Code' sign or symbol placed at the patient's bedside
- C. A 'No-Code' order written and signed on the physician's order sheet
- D. The next of kin's request for 'Do Not Resuscitate' orally or in writing
Correct Answer: C
Rationale: To legally justify not attempting to save a client's life, a healthcare provider must have a 'No-Code' order written and signed on the physician's order sheet. Unless there is a specific order stating that resuscitation should not be performed, failure to do so can be considered negligence. A 'Do Not Resuscitate' statement on the care plan or a symbol at the bedside is not legally valid without the proper medical order. Additionally, a request from the next of kin, whether oral or written, is not a substitute for a signed physician's order.
How does a durable power of attorney differ from a power of attorney?
- A. It is granted by the court on behalf of an incompetent individual.
- B. It stays in effect if the individual granting it becomes incompetent.
- C. It goes into effect only after an individual becomes incompetent.
- D. It includes responsibility for managing an individual's financial assets.
Correct Answer: B
Rationale: A durable power of attorney allows competent individuals to appoint someone else to make decisions on their behalf in the event they become incompetent. Choice A is incorrect because a durable power of attorney is typically granted by the individual themselves, not the court. Choice C is incorrect as a durable power of attorney can be effective both before and after incompetency. Choice D is incorrect because managing financial assets is just one aspect of the authority granted by a power of attorney, not specifically for a durable power of attorney.