Nokea
Nurse M obtains a signature on an informed consent form from Mr. Y, who is later shown to have a fluctuating level of mental competency. In this case, what is Nurse M's most likely legal position?
- A. Freedom from liability because Mr. Y signed the form
- B. Possibly liable for a violation of Mr. Y's rights
- C. Liable unless a malpractice insurance policy is in effect
- D. Not liable because no family member had a durable power of attorney
Correct Answer: B
Rationale: An informed consent may be considered invalid if the patient does not fully understand what he or she is signing. Patients with a fluctuating level of mental function are incapable of granting legally sound consent. Nurse M could be held liable for a violation of Mr. Y's rights as he did not have the capacity to provide informed consent. The presence of an insurance policy and the legal status of family members are irrelevant in this context and do not absolve Nurse M of potential liability.
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A 52-year-old woman is preparing to have her father move into her home after his discharge from the hospital. Which of the following subjects should the discharge planning nurse prioritize when preparing the woman for her new caregiving role?
- A. The availability and scope of community resources
- B. The importance of her own self-care and techniques for maximizing it
- C. Assertiveness training to ensure she can set limits
- D. Management of finances
Correct Answer: B
Rationale: The correct answer is B. It is crucial for the discharge planning nurse to prioritize the importance of the woman's self-care and provide techniques for maximizing it. When taking on a caregiving role, the caregiver's well-being is essential to ensure effective care for the patient. While community resources (choice A) are important, the immediate focus should be on self-care. Assertiveness training (choice C) and financial management (choice D) are also significant but not as critical as self-care for the caregiver in this scenario.
Which of the following statements by family caregivers would the nurse consider most indicative of elder abuse?
- A. Mom can't handle her own money anymore, so I've had to take over her banking.
- B. When my dad starts wandering around the house, I give him sleeping pills until he calms down and falls asleep in his chair.
- C. My mother says she wants me to do everything for her, but I think it's better if she keeps on doing everything she's still capable of.
- D. I get so frustrated because my father used to be so competent, and now he can't even use a toilet.
Correct Answer: B
Rationale: The correct answer is B. The statement 'When my dad starts wandering around the house, I give him sleeping pills until he calms down and falls asleep in his chair' is most indicative of elder abuse as it involves the inappropriate use of chemical restraints. This practice can harm the elderly and is considered a form of abuse. Choices A, C, and D do not demonstrate elder abuse. Choice A may be a responsible action depending on the circumstances, choice C reflects a positive philosophy of care, and choice D expresses frustration but does not constitute abuse.
A nurse is providing end-of-life care to an older female client who practices Judaism. Which intervention would the nurse identify as potentially problematic for this client and her family?
- A. The client requires transfusions of packed red blood cells during care.
- B. Assessment by a male health care provider was required.
- C. An autopsy was ordered due to the client's unique disease etiology.
- D. A do-not-resuscitate (DNR) order was recommended by the care team.
Correct Answer: C
Rationale: The correct answer is C. Autopsy is often opposed in the context of Jewish religious and cultural beliefs, as it is seen as desecration of the body. While a person who is a Jehovah's Witness would be opposed to blood transfusions (choice A), a Muslim client may prefer to be cared for by someone of the same gender (choice B). A DNR order (choice D) is not noted to be a particular issue in the context of Jewish culture.
An older adult client tells the nurse that blockage of qi in one of the body's meridians is causing severe headaches. The health care provider has diagnosed migraines and has prescribed a triptan drug. Which action would be most appropriate for the nurse to implement?
- A. Suggest that the prescribed medicine may stimulate the flow of qi
- B. Explain the vasoconstrictive and serotonin-moderating action of triptan
- C. Instruct the client to take as many doses as needed for relief
- D. Caution the client that the headaches will grow worse if the client fails to take the medication
Correct Answer: A
Rationale: Qi is the life force that circulates through the body in invisible pathways called meridians. In this scenario, the client believes that the blockage of qi is causing severe headaches. While explaining the scientific principles underlying the drug action could be valuable, it's crucial to consider the client's belief system. Therefore, the most appropriate response is to suggest that the prescribed medicine may stimulate the flow of qi, aligning with the client's perspective. Choice B, explaining the vasoconstrictive and serotonin-moderating action of triptan, does not address the client's concerns about qi blockage. Choice C, instructing the client to take as many doses as needed, can lead to potential medication misuse. Choice D, cautioning the client about worsening headaches without medication, may induce fear and hinder effective communication with the client.
Which of the following actions can a nurse safely take without risk of liability?
- A. Questioning a doctor's written orders for medication
- B. Permitting a volunteer to move a patient
- C. Using a blood pressure cuff that is sometimes sticking
- D. Asking a family member to deliver routine medication to a patient's room
Correct Answer: A
Rationale: The correct answer is A: Questioning a doctor's written orders for medication. Under the doctrine of respondent superior, nurses can face liability risks for various actions. Permitting volunteers to move patients, using malfunctioning equipment, or tasking unqualified staff can pose liability risks. Questioning medication orders is a responsibility to ensure patient safety. It is crucial for nurses to clarify any doubts or raise concerns about medication orders to prevent potential harm to patients.