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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A nurse is performing a health history on a client who identifies as Native American/First Nations. Based on familial history and racial disparities, for which health issue should the nurse prepare to monitor in this client?
- A. autoimmune disorders
- B. heart disease
- C. Alzheimer's disease
- D. lung cancer
Correct Answer: B
Rationale: The correct answer is B: heart disease. Heart disease is a major health issue among Native American/First Nations populations, along with diabetes, malignant neoplasm, and unintentional injuries, contributing to a decreased lifespan. Autoimmune disorders, Alzheimer's disease, and lung cancer are not the primary health concerns that the nurse should monitor for in this client. By understanding the prevalent health issues in this population, the nurse can provide targeted care and interventions to promote better health outcomes.
Which of the following family interactions would the nurse most likely interpret as being atypical?
- A. Mr. R states that he and his brother always had a cordial, though somewhat distant, relationship but that they are now quite close.
- B. Mrs. D describes being a grandparent as 'having all the benefits of having children without the headaches and responsibilities.'
- C. Mr. and Mrs. N had a tumultuous relationship for decades but now appear more at ease with one another.
- D. Mr. A states that his ideal living situation would be himself and his adult son and daughter all under the same roof.
Correct Answer: D
Rationale: The correct answer is D. While marital reconciliation, rekindled relationships with siblings, and satisfaction in the role of grandparent are common phenomena among older adults, it is less common for parents and children to see cohabitation as an ideal situation or first preference. Choices A, B, and C reflect common positive family dynamics experienced by older adults, such as improved relationships with siblings, contentment in the grandparent role, and easing of marital tensions over time. On the other hand, choice D stands out as atypical as it suggests an unconventional living arrangement where adult children live with their parent, which is less commonly preferred by older adults.
An investigation into reports of substandard care on the subacute geriatric unit of a hospital has been undertaken. Which of the following events is representative of malpractice on the part of the nursing staff?
- A. A client with a documented history of seizures was left with his bed raised and with bedrails not in place, resulting in a fall and head injury
- B. A client was sent for a colonoscopy, after which it was learned that the client had never given written consent for the procedure
- C. A client with a diagnosis of vascular dementia was found wandering in the hall outside the unit
- D. An immobile client was not turned over the course of a night shift and developed a pressure ulcer on her coccyx
Correct Answer: A
Rationale: Answer A is correct as it includes all the components of malpractice: duty, negligence, and injury. The nursing staff failed in their duty by leaving a client with a documented history of seizures unattended with bedrails not in place, resulting in a fall and head injury. Answer B involves an issue related to consent, which is the responsibility of the physician, not the nursing staff. Answer C does not demonstrate negligence or harm caused by the nursing staff. Answer D also shows negligence by failing to turn an immobile client, leading to a pressure ulcer, but it lacks a direct connection to the duty of the nursing staff in preventing harm.
For which of the following is informed consent required?
- A. Ordering a liquid diet for a post-surgical patient
- B. Listening to a patient reveal his or her private, personal secrets
- C. Giving a patient saline solution to relieve dry nasal passages
- D. Asking a patient to complete a questionnaire for a research study on hospital practices
Correct Answer: D
Rationale: Informed consent is required when asking a patient to participate in a research study, as mentioned in choice D. Choices A, B, and C involve routine care measures that do not require specific informed consent. Ordering a liquid diet, providing saline solution for dry nasal passages, or listening to a patient's personal secrets are part of standard care and do not typically necessitate formal consent beyond general consent for treatment.
Nurse B arrives for his regular night shift at a care facility for the aged. Due to a family emergency, he has only slept for 3 hours since his last shift. One of Nurse B's aides calls in sick, and there is no one available to replace the aide that night. With no help accessible, Nurse B lifts an obese patient from a wheelchair into a bed alone. Short on time and assistance, Nurse B decides to forgo the patient's evening bath. Legally, what does Nurse B most likely face?
- A. Little risk of liability because he is doing his best under difficult circumstances
- B. Immediate termination for dereliction of duty
- C. Liability if a pattern of negligence is identified in his performance evaluation
- D. A high risk of liability for his actions
Correct Answer: D
Rationale: In this scenario, Nurse B faces a high risk of liability for his actions due to several factors. Working with insufficient resources, failing to adhere to policies and procedures, taking shortcuts, and working while highly stressed are all situations that increase the risk of liability. Nurse B's decision to lift an obese patient without assistance and skip the patient's evening bath due to time constraints and lack of help are clear examples of actions that can lead to legal consequences. Choices A, B, and C are incorrect because the circumstances described in the scenario indicate a higher likelihood of liability due to the factors mentioned above.