Nokea
During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy?
- A. An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway.
- B. A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power.
- C. A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call.
- D. A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.
Correct Answer: A
Rationale: The correct answer is A because denying the older person with Alzheimer's disease the right to ambulate violates their autonomy by restricting their freedom to make choices about their own body and movement. Autonomy is the ethical principle that respects an individual's right to make decisions about their own health and well-being. In this situation, the person should have the autonomy to decide whether or not they want to ambulate, even if they have advanced Alzheimer's disease.
Choice B is incorrect because the mentally competent adult has the right to refuse medical treatment based on their beliefs, which is an expression of autonomy.
Choice C is incorrect because the mentally competent visitor has the right to refuse examination, which is also an expression of autonomy.
Choice D is incorrect because the mentally competent adult has the right to refuse a local anesthetic, which is also an expression of autonomy.
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The role of the Clinical Nurse Leader (CNL) would include:
- A. diagnosing a patient with pneumonia and prescribing antibiotics.
- B. teaching members of a faith community how to avoid skin cancer and referring those with suspicious lesions.
- C. participating in the team who is investigating possible abuse of elderly persons by members of a gang known to sell illegal drugs.
- D. coordinating care of a patient admitted 4 days ago with stage IV heart failure and chronic bronchitis by revising care plan to include ambulation 50 feet with assistance.
Correct Answer: D
Rationale: The correct answer is D because the role of a Clinical Nurse Leader (CNL) involves coordinating and managing the care of patients. In this scenario, the CNL is revising the care plan for a patient with complex health issues, such as heart failure and chronic bronchitis, by incorporating specific interventions like ambulation with assistance. This aligns with the core responsibilities of a CNL, which include care coordination, implementation of evidence-based practice, and leadership in interdisciplinary teams.
Choice A is incorrect because nurses, including CNLs, do not have the authority to diagnose and prescribe medications, as this falls under the scope of practice of a physician or advanced practice nurse.
Choice B is incorrect because while health education and referral are important aspects of nursing practice, they are more aligned with the role of a community health nurse rather than a CNL.
Choice C is incorrect because investigating abuse and criminal activities is beyond the scope of a CNL's role, as their focus is primarily on
A family requests that no additional heroic measures be instituted for their terminally ill mother who has advance directives in place. The nurse respects this decision in keeping with the principle of:
- A. accountability.
- B. autonomy.
- C. nonmaleficence.
- D. veracity.
Correct Answer: B
Rationale: The correct answer is B: autonomy. Autonomy refers to respecting the right of individuals to make their own decisions about their healthcare. In this scenario, the family's request to honor the terminally ill mother's advance directives aligns with the principle of autonomy as it acknowledges her right to make decisions about her own care. Accountability (A) pertains to taking responsibility for one's actions, nonmaleficence (C) involves avoiding harm, and veracity (D) refers to truthfulness. While these principles are important in healthcare, in this specific case, autonomy takes precedence as it respects the patient's wishes.
Which nursing model is referred to as the "class without walls"?
- A. Articulation
- B. Career ladder (2 +
- C. Nightingale’s Environmental Nursing Theory
- D. Online Nursing Learning Framework
Correct Answer: A
Rationale: The correct answer is A: Articulation. This nursing model is referred to as the "class without walls" because it focuses on seamless academic progression and collaboration between educational institutions. Articulation promotes a smooth transition of nursing students from one level of education to another, eliminating barriers and creating a cohesive learning experience. The other choices (B, C, D) do not specifically emphasize the concept of breaking down walls or barriers in education like the Articulation model does.
The nurse manager meets with upper management to share strategic goals agreed upon by her staff for their individual nursing unit as the first step to begin budget negotiations. One strategic goal is that staff will have access to technology that will allow them to incorporate point-of-care devices for all RNs. The second goal is to improve RNs' ability to recognize critical indicators that a patient's health status is deteriorating through advanced health assessment skills. During the meeting the manager discusses the strategy options and selecting the one that works for the unit. Which type of budget development is used?
- A. Iterative
- B. Top-down
- C. Participatory
- D. Zero-based
Correct Answer: C
Rationale: The correct answer is C: Participatory. In participatory budget development, input is gathered from various levels within the organization, such as staff and managers. In this scenario, the nurse manager met with her staff to establish strategic goals before budget negotiations, indicating a participatory approach. This allows for staff buy-in and ownership of the goals.
A: Iterative budget development involves refining a budget through multiple rounds of review, which is not explicitly mentioned in the scenario.
B: Top-down budget development is characterized by decisions made by upper management without input from lower levels, contradicting the scenario where staff provided input.
D: Zero-based budgeting starts from scratch without considering previous budgets, which is not evident in the scenario where goals were established based on staff input.
In summary, the participatory budget development is the appropriate choice in this scenario as it aligns with the collaborative approach taken by the nurse manager and her staff in setting strategic goals before budget negotiations.
An RN delegates to the unlicensed assistive personnel (UAP) the task of performing blood pressure checks for a group of patients on a nursing unit. The UAP accepts the task and is responsible for:
- A. delegating the task to another UAP if he or she does not have the time or skill to complete the task.
- B. keeping the RN informed of any abnormal blood pressure readings.
- C. calling the physician when the patient's vital signs are not within established parameters.
- D. informing the dietary department to initiate a low-sodium diet for patients who are hypertensive.
Correct Answer: B
Rationale: The correct answer is B because keeping the RN informed of any abnormal blood pressure readings is an essential part of the UAP's responsibility. This ensures that the RN is aware of any potential issues with the patients' health and can intervene if necessary. It is important for the UAP to communicate such vital information promptly to the RN, who has the clinical expertise to assess the situation and make appropriate decisions.
Choice A is incorrect because the UAP should not delegate tasks to another UAP without prior authorization from the RN. Choice C is incorrect because calling the physician directly is beyond the scope of practice for a UAP. Choice D is incorrect because initiating a low-sodium diet for hypertensive patients is a clinical decision that should be made by the RN or physician, not the UAP.