Nokea
Examples of preservation of self-integrity include all of the following except:
- A. Using assistive equipment to move bariatric clients
- B. Participating in wellness programs
- C. Accepting the challenge of caring for clients with oppositional beliefs or practices
- D. Using hand hygiene and personal protective equipment
Correct Answer: C
Rationale: Preservation of self-integrity involves actions that support the nurse's well-being and ethical standards. Using assistive equipment to move bariatric clients and practicing hand hygiene and personal protective equipment are essential aspects of maintaining physical health and safety, contributing to self-care. Participating in wellness programs further enhances self-care by promoting overall well-being. However, accepting the challenge of caring for clients with oppositional beliefs or practices can be emotionally taxing and may compromise a nurse's self-integrity if it leads to significant moral distress or ethical conflicts. In such situations, it is important for nurses to prioritize their well-being and ethical values by seeking alternative solutions or support.
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A patient is being seen in the crisis unit reporting that poison letters are coming in the mail. The patient has no history of psychiatric illness. Which group of the following medications would the patient most likely be started on?
- A. Aripiprazole (Abilify)
- B. Risperidone (Risperdal Consta)
- C. Fluphenazine (Prolixin)
- D. Fluoxetine (Prozac)
Correct Answer: A
Rationale: In this scenario, where a patient without a history of psychiatric illness is experiencing psychotic symptoms like believing in poison letters, the most suitable medication group to start the patient on would be atypical antipsychotics. Aripiprazole (Abilify) belongs to this group and is preferred due to its efficacy with fewer side effects compared to conventional antipsychotics. Risperidone (Risperdal Consta) is also an atypical antipsychotic but is usually indicated after stabilizing the patient with oral medications. Fluphenazine (Prolixin) is a conventional antipsychotic, which is less favored due to its side effect profile. Fluoxetine (Prozac) is an antidepressant and is not the first-line treatment for psychotic symptoms.
What question must the nurse ask when formulating a nursing diagnosis?
- A. What diagnosis did the physician make for this client?
- B. What is the issue that I can solve for this client?
- C. What physician orders will resolve this issue?
- D. What underlying disease does this client have?
Correct Answer: B
Rationale: When formulating a nursing diagnosis, the nurse should focus on identifying the client's specific health problems that can be addressed through nursing interventions. The correct answer emphasizes the nurse's role in identifying and addressing client-specific issues through nursing care. Choice A is incorrect because nursing diagnoses are distinct from medical diagnoses made by physicians. Choice C is incorrect as it focuses on physician orders rather than the nurse's role in diagnosing and addressing client problems. Choice D is incorrect because it pertains to identifying underlying diseases, which is not the primary focus of nursing diagnoses.
What is involved in obtaining informed consent?
- A. An explanation of the reasons for the procedure
- B. A signature on a form indicating the client agrees to the procedure
- C. A statement affirming liability if complications arise during the procedure
- D. Both A and C
Correct Answer: A
Rationale: Informed consent involves providing the client with an explanation of the reasons for the procedure, the potential risks, benefits, and available alternatives. It is essential for the healthcare provider to ensure that the client understands the information provided before agreeing to the procedure. While obtaining a signature on a consent form is part of the process, it is not the sole indicator of informed consent. Option C, which mentions liability statements, is incorrect as informed consent focuses on ensuring the client understands the procedure, not on affirming liability. Therefore, the correct answer is the explanation of the reasons for the procedure.
At the beginning of the shift, a nurse receives report for her daily assignment. Which of the following situations should the nurse give first priority?
- A. A diabetic client with a blood glucose level of 195 mg/dL
- B. A family member of an elderly client who has questions
- C. A client with COPD with an oxygen saturation of 84%
- D. A client who requires assistance to use the bathroom
Correct Answer: C
Rationale: When prioritizing the needs of clients, the nurse must begin with the unstable client or manage conditions that affect airway, breathing, or circulation first. The client with COPD has a condition that affects breathing and is exhibiting decreased oxygen saturation levels; therefore, this client should be the first priority. Option A, the diabetic client with a blood glucose level of 195 mg/dL, does not present an immediate threat to airway, breathing, or circulation. Option B, addressing questions from a family member, is important but can be addressed after addressing critical patient needs. Option D, assisting a client to use the bathroom, is a routine task that can be prioritized after addressing urgent medical needs.
Which of the following is an example of a living will?
- A. A client's son has been appointed to make his healthcare decisions if he becomes incapacitated
- B. A client has designated which of his children will receive his home and property before he dies
- C. A client has instructions that he does not want to be resuscitated through chest compressions if his heart stops beating
- D. A client designates what type of burial or cremation services he would want after his death
Correct Answer: C
Rationale: A living will is a type of advanced directive that a client develops to stipulate his preferences for healthcare in the event that he is unable to do so. This includes specific instructions about medical treatments in certain situations. Choice C is the correct answer as it reflects a scenario where the client has clearly outlined their preference regarding resuscitation through chest compressions. Choices A, B, and D do not pertain to a living will. Choice A involves a healthcare proxy or agent, choice B involves a will or estate planning, and choice D involves funeral or burial arrangements, which are not part of a living will.