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The Health Care Reform Act provides insurance for all U.S. citizens and legal residents presenting far-reaching ethical considerations related to diverse individual patient health care beliefs for those delivering nursing care. Nurses must consider their civil rights under the rights of conscience and how new health care agendas such as the Patient Protection and Affordable Care Act (PPACA) could affect their practice in situations that may conflict with their own belief system. Today's practicing nurse must:
- A. remember it is one's professional duty to render patient-centered care"even when it is in direct conflict with the nurse's own beliefs"or be held liable for withholding treatment.
- B. consider whether the right to act according to one's inner beliefs will continue to be permissible when federal health insurance becomes fully enacted.
- C. discuss with the patient and family different options in hopes they will accept the nurse's health care beliefs.
- D. suggest to the hospital administration that they not accept federal funding to prevent controversial health practices.
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct:
1. Professional duty: Nurses have a duty to provide patient-centered care regardless of personal beliefs.
2. Legal liability: Withholding treatment based on personal beliefs can lead to legal consequences.
3. Ethical considerations: Nurses must prioritize patient care over personal beliefs.
4. Rights of conscience: Nurses may have the right to refuse to participate in certain treatments, but they must still ensure patient care.
5. Patient-centered care: Nurses must respect patient autonomy and provide care based on the patient's wishes.
Summary of why the other choices are incorrect:
B. Irrelevant to the nurse's duty to provide patient-centered care.
C. Nurses should not impose their beliefs on patients but should respect and support their choices.
D. Suggesting the hospital not accept federal funding does not address the nurse's duty to provide patient-centered care.
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A nurse would like to advocate for increased protective services and reporting mechanisms for elder abuse and attends the "meet the candidate" session at the town hall meeting. This is an important time for the nurse to:
- A. educate the public about the nurse's political platform.
- B. be spontaneous and not deliver a rehearsed speech.
- C. address the person as "candidate" rather than using a first name that implies a working relationship.
- D. learn what the key issues are in the candidate's platform.
Correct Answer: D
Rationale: The correct answer is D because the nurse's goal is to advocate for increased protective services for elder abuse. By learning about the key issues in the candidate's platform, the nurse can identify if the candidate supports policies related to elder abuse. This information will help the nurse assess the candidate's alignment with their advocacy goals and determine if the candidate is a suitable ally in advancing elder abuse prevention measures.
A, B, and C are incorrect because:
A: Educating the public about the nurse's political platform is not the primary purpose of attending the session.
B: Being spontaneous may lead to an ineffective communication strategy without proper preparation.
C: Addressing the candidate by their first name or title is a matter of personal preference and does not directly impact the nurse's advocacy efforts.
A nurse develops a new nursing theory related to stress and viability. The nurse determines the theory accounts for historical events in which soldiers suffering from the stress of inadequate clothing to protect them from the cold and lack of correspondence from home had an increased mortality related to gunshot wounds. The theory will predict gunshot victims' need for proper clothing and letters from significant others as they serve in Iraq. Which criterion for theory acceptance is being validated?
- A. Inclusiveness
- B. Consistency
- C. Accuracy
- D. Simplicity
Correct Answer: C
Rationale: The correct answer is C: Accuracy. The nurse's theory is being validated based on its ability to accurately predict the need for proper clothing and letters from significant others for soldiers serving in Iraq. This criterion is essential for theory acceptance as it demonstrates the theory's ability to make accurate predictions based on historical events.
Inclusiveness (A) refers to the theory's ability to encompass a wide range of phenomena, which is not explicitly demonstrated in this scenario. Consistency (B) refers to the theory's internal coherence and agreement with existing knowledge, which is not the focus of the nurse's validation process in this case. Simplicity (D) refers to the theory's clarity and parsimony, which is not the primary criterion being validated here.
In summary, accuracy is the most relevant criterion being validated in this scenario as the nurse's theory is being assessed based on its predictive accuracy in relation to the soldiers' needs in Iraq.
A Hispanic patient is visited by several family members and the nurse witnessed one visitor who pinches a piece of skin at the waist. The nurse asks the purpose and learns the "provider" is listening for a snap from the abdominal region, which is then repeated several times. The patient most likely suffers from:
- A. mal ojo.
- B. susto.
- C. bilis.
- D. empacho.
Correct Answer: D
Rationale: The correct answer is D: empacho. Empacho is a traditional Hispanic folk illness characterized by a blockage in the digestive system. In this scenario, the behavior of pinching the skin and listening for a snap in the abdominal region aligns with the common practice associated with empacho diagnosis. The family member is likely trying to detect an abnormal sound, indicating a blockage in the intestines. The other choices (A: mal ojo, B: susto, C: bilis) do not fit the description of the observed behavior and symptoms. Mal ojo refers to the evil eye, susto is a fright-related illness, and bilis pertains to an imbalance of bodily fluids, none of which involve the specific diagnostic behavior described in the scenario.
A nurse works on a unit where electronic health records (EHR) are being initiated and asks, "What is meant by 'meaningful use' standards that are in our education packet?" The best answer is that "meaningful use":
- A. identifies a set of EHR proficiencies and benchmarks that EHR systems must meet to be certain that they are functioning to their maximum capacity and meeting this standard allows companies/organizations to qualify for funds to defray cost of the EHR from Medicare.
- B. refers to training competencies that all users must achieve to be able to access and transfer patient data/information.
- C. refers to a requirement that at least 50% plus one of all patients have data entered into the EHR.
- D. the requirement that rigorous confidentiality security is in place to protect all patient information from sources which have no right to the data.
Correct Answer: A
Rationale: The correct answer is A because "meaningful use" standards in EHR refer to specific criteria that healthcare providers must meet to receive incentives for using EHR effectively. This includes improving quality, safety, efficiency, and reducing health disparities. By meeting these benchmarks, providers can qualify for funds from Medicare.
Choice B is incorrect because "meaningful use" is not just about training competencies but about how EHR systems are used to improve patient care.
Choice C is incorrect as it misinterprets the concept of meaningful use. It is not about a specific percentage of patients with data entered, but about the overall impact of EHR on healthcare delivery.
Choice D is incorrect because while confidentiality and security are important aspects of EHR, they are not the sole focus of meaningful use standards.
A student nurse who is preparing to graduate and take the licensure examination asks, "What is compulsory licensure?" The appropriate response of the nursing advisor is which of the following?
- A. All candidates wishing to take the licensure examination must pass a drug screen.
- B. Candidates must not have a felony conviction.
- C. To practice as an RN, the nurse must be licensed as an RN.
- D. An impaired nurse must sign a legal document to acknowledge limitations on his or her practice.
Correct Answer: C
Rationale: The correct answer is C because compulsory licensure means that in order to practice as an RN, the nurse must be licensed as an RN. This is a fundamental requirement for anyone wanting to work as a registered nurse to ensure they meet the necessary qualifications and standards set by the licensing board.
Choice A is incorrect as passing a drug screen is not the definition of compulsory licensure. Choice B is incorrect as having a felony conviction may impact eligibility for licensure but is not the definition of compulsory licensure. Choice D is incorrect as acknowledging limitations due to impairment is related to professional conduct but not specifically about licensure requirements.