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How can the nurse best respond to this situation?
- A. The nurse should accept that the relationship plays a positive role for the man.
- B. The nurse should organize a family meeting that includes both the children and the man's partner in an effort to facilitate reconciliation.
- C. The nurse should document the children's concerns and investigate the truth of their claims.
- D. The nurse should ask the partner to demonstrate that she is not a negative influence on the resident.
Correct Answer: A
Rationale: In this scenario, the nurse should respect the father's perspective and accept that the relationship with his common-law partner may indeed be positive and beneficial for him. The nurse's role is to support the patient's autonomy and decisions, especially when there are no legal concerns or signs of abuse. Organizing a family meeting (Choice B) might be premature without first acknowledging the father's viewpoint. Documenting concerns and investigating (Choice C) may create unnecessary conflict and breach the father's trust. Asking the partner to prove herself (Choice D) could strain the relationship further and is not within the nurse's role unless there are clear signs of harm or abuse.
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In which of the following situations would the use of physical restraints most likely be justified?
- A. Mr. Y is agitated and aggressive while experiencing severe alcohol withdrawal and is not responding to chemical sedation.
- B. Mrs. U, diagnosed with dementia, was found wandering outside the hospital, and nurses have been unable to redirect her to stay on the unit.
- C. Mr. I is delirious during the acute stage of his urinary tract infection and is ringing the call bell nearly continuously.
- D. Mrs. T is frequently entering other patients' rooms and attempting to crawl into others' beds.
Correct Answer: A
Rationale: Answer A is the correct choice because it describes a situation where the client poses a risk due to agitation and aggression during severe alcohol withdrawal, and chemical sedation has not been effective. In such cases, physical restraints may be justified as a last resort to ensure the safety of the client and others. Choices B, C, and D present scenarios where alternative strategies like redirection, addressing delirium, or implementing behavioral interventions should be attempted before considering physical restraints.
How does the doctrine of respondent superior affect nurses?
- A. Liable for injury resulting from advice given to a member of a patient's family
- B. Responsible for double-checking the doses of medication ordered by a physician
- C. Responsible for the actions of the staff they supervise
- D. Obligated to obtain informed consent for any diagnostic procedure
Correct Answer: C
Rationale: The correct answer is C. The doctrine of respondent superior holds that supervisors are accountable not only for their own actions but also for the actions of the staff they oversee. This means that nurses, as supervisors, are responsible for ensuring that the actions of their staff comply with established protocols and standards of care. Choices A, B, and D are incorrect because they do not directly relate to the principle of respondent superior. Nurses may have other responsibilities related to giving advice, medication administration, and obtaining consent, but the doctrine of respondent superior specifically pertains to the accountability of supervisors for the actions of their subordinates.
An elderly man has relied on one of his sons for his care. Now the son has become very involved with a religion other than the one in which he was raised. As a result, he now refuses to help his father. What can a nurse do to help in this family situation?
- A. Set up a family conference that includes the son
- B. Bring in help from other family members or outside
- C. Insist that the son help, along with other family members
- D. Ask the family's own spiritual adviser to intervene
Correct Answer: A
Rationale: In this complex family situation, it is essential to approach the issue with sensitivity and understanding. Setting up a family conference that includes the son is the most appropriate action for the nurse to take. While it may seem challenging, there is a possibility that involving the son in a family discussion can help him understand the impact of his actions on his father and the rest of the family. By including him in the conversation, the son may realize the importance of his role in caring for his father. Insisting that the son help, along with other family members, could lead to resistance and further alienation. Asking the family's spiritual adviser to intervene may not be effective if the son is rebelling against the family's religion. If the family conference does not yield positive results, then bringing in help from other family members or an outside caregiver may become necessary to ensure the elderly man receives the care he needs.
During a family meeting that the nurse organized during an older adult's discharge planning from the hospital, there is visible animosity between the son and daughter of the patient. What should the nurse's initial response be to the apparent family dysfunction?
- A. Teach the patient's children alternative methods of interaction.
- B. Encourage the family to choose one spokesperson to represent all the children.
- C. Organize separate meetings with the son and with the daughter.
- D. Assess the family history and the nature of the son and daughter's relationship.
Correct Answer: D
Rationale: The correct initial response for the nurse in this situation is to assess the family history and the nature of the son and daughter's relationship. By gathering data and identifying factors contributing to the dysfunction, the nurse can better understand the underlying issues and dynamics at play. Teaching alternative methods of interaction (Choice A) may not address the root cause of the animosity. Encouraging one spokesperson for the family (Choice B) may overlook individual concerns. Organizing separate meetings (Choice C) may not provide a holistic view of the family dynamics and may not address the issues affecting the family unit as a whole. Therefore, assessing the family history and relationship dynamics is essential for effective intervention and resolution of the family dysfunction.
Following a recent lawsuit that implicated one of their colleagues, the nursing staff at an assisted-living facility are especially aware of the need to safeguard themselves legally. Which of the following measures should the nurses take? Select one that does not apply.
- A. Investigate whether their liability insurance is sufficient
- B. Ensure that work performed by unlicensed care staff under their supervision is adequate
- C. Avoid admitting residents who have living wills or advance directives
- D. Assess the competence of employees under their supervision
Correct Answer: C
Rationale: Denying admission to residents with living wills or advance directives is not a legal safeguard measure and may be considered discriminatory. Measures like investigating liability insurance adequacy, ensuring adequate work by unlicensed staff, and assessing employee competence are all valid ways for nurses to protect themselves legally. These measures help in ensuring proper care, reducing risks, and maintaining a high standard of practice.