Nokea
One of your staff nurses asks for your advice because a patient refuses to sign a consent for surgery. The patient says that he won't sign because he doesn't understand the nature of the surgery. You advise that:
- A. The patient has a right to choose not to consent.
- B. Consent must not be coerced.
- C. Consent for life-saving surgery is always mandatory.
- D. The patient must sign the consent because the doctor wants him to sign.
- E. Minors can consent to procedures in the absence of parents or guardians.
Correct Answer: A,B
Rationale: Correct Answer: A,B
Rationale:
A: The patient has the right to choose not to consent: It is essential to respect the autonomy and self-determination of the patient in making healthcare decisions. If the patient does not understand the nature of the surgery, forcing them to sign would violate their autonomy.
B: Consent must not be coerced: Coercion undermines the voluntary nature of consent. Patients should make decisions freely without pressure or influence from healthcare providers. Respecting the patient's decision-making process is crucial for ethical care.
Summary:
C: Consent for life-saving surgery is always mandatory: This statement is incorrect as consent should still be obtained even for life-saving procedures. It is about respecting the patient's autonomy and involving them in the decision-making process.
D: The patient must sign the consent because the doctor wants him to sign: This choice is incorrect as it disregards the patient's right to make an informed decision based on understanding the procedure.
E: Minors can consent to
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A floor manager discovers widespread dissatisfaction and a high turnover rate amongst LPN and certified nursing assistants (CNA). Which of the following strategies might motivate the staff and lead to enhanced job satisfaction?
- A. Allow LPNs and CNAs to perform tasks beyond their scope of practice.
- B. Establish a rewards program to recognize achievements of the staff.
- C. Hire additional staff so individual workloads are lessened.
- D. Improve the working conditions of the unit by investing in ergonomic chairs.
Correct Answer: B
Rationale: The correct answer is B: Establish a rewards program to recognize achievements of the staff. This strategy can motivate the LPNs and CNAs by providing positive reinforcement for their hard work and dedication. Recognizing their achievements can boost morale, increase job satisfaction, and encourage them to continue performing well. This approach acknowledges their efforts and creates a sense of appreciation, leading to a more positive work environment.
Choice A is incorrect as allowing LPNs and CNAs to perform tasks beyond their scope of practice can lead to legal and safety issues. Choice C of hiring additional staff may help with workload but may not directly address job satisfaction. Choice D of investing in ergonomic chairs can improve physical comfort but may not address the underlying issues causing dissatisfaction.
Mary is a newly-hired, new graduate nurse. Mary adapts her practice to imitate her co-workers on the unit. She is demonstrating:
- A. cultural awareness.
- B. cultural sensitivity.
- C. acculturation.
- D. cultural marginality.
Correct Answer: C
Rationale: Mary is demonstrating acculturation by adapting her practice to imitate her co-workers. Acculturation involves adopting the cultural norms and behaviors of a dominant group. In this scenario, Mary is assimilating into the culture of her workplace. Cultural awareness (A) is about understanding and respecting different cultures. Cultural sensitivity (B) is being aware of and respectful towards different cultures. Cultural marginality (D) refers to feeling disconnected from one's own culture and the dominant culture. In this case, Mary is actively assimilating, not feeling disconnected. Therefore, the correct answer is C.
Which of the following is most accurate regarding evidence-based practice?
- A. Evidence-based practice should focus solely on the advancement of the nursing profession, while prohibiting involvement of other healthcare disciplines.
- B. Evidence-based practice replaces continuous quality improvement.
- C. Evidence-based practice integrates the best research evidence with clinical expertise and the patient's unique values and circumstances in making care decisions.
- D. Evidence-based practice began with medicine and assists in determining which medical models can be applied in nursing practice.
Correct Answer: C
Rationale: The correct answer is C because evidence-based practice involves integrating research evidence, clinical expertise, and patient values to make informed care decisions. This approach ensures that patient care is individualized and based on the best available evidence. Choice A is incorrect as evidence-based practice encourages collaboration across healthcare disciplines. Choice B is incorrect as evidence-based practice complements continuous quality improvement efforts rather than replacing them. Choice D is incorrect as evidence-based practice is a separate entity from medicine and focuses on nursing-specific interventions.
To help staff nurses prepare for evidence-based practice, which strategy is NOT appropriate for the nurse manager to recommend?
- A. Establishing a journal club.
- B. Encouraging staff to join a professional association.
- C. Instituting mandatory writing assignments discussing a chosen best-practice article.
- D. Creating an incentive program for staff to pursue a specialty certification.
Correct Answer: C
Rationale: The correct answer is C: Instituting mandatory writing assignments discussing a chosen best-practice article. This is not an appropriate strategy for the nurse manager to recommend because mandating writing assignments may create resistance and decrease staff engagement. Instead, fostering a voluntary learning environment through options like journal clubs (A), professional association memberships (B), and incentive programs (D) can motivate staff to engage in evidence-based practice without imposing mandatory tasks. Encouraging autonomy and interest-driven learning is more effective than enforcing obligations.
Volunteers in a study are assigned randomly to groups. Some of the volunteers receive an herbal supplement that is reputed to control nausea, and some of the volunteers are assigned to a control group where a placebo is administered. This is an example of a(n):
- A. longitudinal study.
- B. appraisal tool.
- C. meta-analysis.
- D. RCT.
Correct Answer: D
Rationale: The correct answer is D: RCT (Randomized Controlled Trial). In this study design, volunteers are randomly assigned to groups to receive either the herbal supplement or a placebo, allowing for comparison of the effects. This random assignment helps minimize bias and ensures that any observed differences between the groups are likely due to the treatment. A longitudinal study (A) follows subjects over an extended period, which is not described here. An appraisal tool (B) is used to evaluate research quality, not a study design. Meta-analysis (C) involves combining results from multiple studies, not assigning treatments.