Ethics and Issues in Contemporary Nursing

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The novice nurse calls a supervisor and requests that a "float nurse" be assigned to help with all "assessments of new admissions and postoperative patients." The supervisor asks, "How many admissions and surgery patients have you received?" The novice nurse becomes flustered because she has not checked the census but simply bases the need on feeling overwhelmed. This situation best indicates a lack of skills.

  • A. organizational
  • B. communication
  • C. interpersonal
  • D. clinical
Correct Answer: A

Rationale: The correct answer is A: organizational skills. The novice nurse's inability to assess the number of admissions and postoperative patients before requesting assistance indicates a lack of organizational skills. Organizational skills involve prioritizing tasks, managing time efficiently, and planning ahead. In this scenario, the nurse failed to gather essential information before making a decision, leading to inefficiency and potential misallocation of resources.

Choice B: communication skills, is not the best answer because the issue is not primarily related to communication breakdown but rather a lack of organizational skills. Choice C: interpersonal skills, is not the best answer because the problem does not stem from the nurse's ability to interact with others but rather from her inability to organize her workload effectively. Choice D: clinical skills, is not the best answer because the situation is more about managing workload and resources rather than clinical knowledge or expertise.

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A patient with complicated diabetes is scheduled for a below the knee amputation at 7 AM. The surgical team adheres to the 2012 National Patient Safety Goals by implementing which protocols? (select all that apply)

  • A. The surgical team asks the patient to verify his or her name, type of surgery, and limb to be removed.
  • B. Ask each member of the surgical team to provide a copy of licensure and, if applicable, certification to patient and family.
  • C. The surgical team uses the chart number and name/hospital number to ensure they have the correct patient.
  • D. Mark the procedure site with "X" and again ask the patient to verify correct site.
Correct Answer: A

Rationale: The correct answer is A because it aligns with the 2012 National Patient Safety Goals, specifically the goal of improving the accuracy of patient identification. By asking the patient to confirm their name, type of surgery, and limb to be removed, the surgical team is ensuring that they have the correct patient and are performing the correct procedure. This protocol helps prevent errors and ensures patient safety.

Option B is incorrect because asking for licensure and certification does not directly relate to patient safety or accurate patient identification.

Option C is incorrect because relying solely on chart numbers or hospital numbers may not be sufficient to prevent errors in patient identification.

Option D is incorrect because while marking the procedure site is important, relying solely on the patient to verify the correct site may not be as effective as having the healthcare team confirm this information with the patient.

A nurse is given a referral to make a home visit to a Russian immigrant. The nurse knows very little about the health beliefs of this ethnic group. To research this group, she can use an Internet search engine and enter the term "Russian cultures" or "Russian health beliefs." To obtain more generalized information, she could also search under:

  • A. federally recognized minorities.
  • B. marginalized populations.
  • C. Asian/Pacific Islander cultures.
  • D. Latino cultures.
Correct Answer: A

Rationale: The correct answer is A: federally recognized minorities. This is because Russian immigrants are considered a federally recognized minority group in the United States. By searching under this category, the nurse can find specific and relevant information about the health beliefs and practices of this particular ethnic group. Choices B, C, and D are incorrect because they do not specifically pertain to the Russian immigrant population. Marginalized populations (B) may include various minority groups but may not provide specific information about Russian immigrants. Similarly, Asian/Pacific Islander cultures (C) and Latino cultures (D) do not encompass the unique health beliefs and practices of Russian immigrants.

A nurse tallies the patient satisfaction surveys and approves the use of an agency nurse because of the high census. This nurse is involved in which nursing role?

  • A. Change agent
  • B. Educator
  • C. Manager
  • D. Coordinator
Correct Answer: C

Rationale: The correct answer is C: Manager. In this scenario, the nurse is making decisions related to staffing and resource management based on patient census, which falls under the responsibilities of a nurse manager. A manager oversees the organization and coordination of nursing care to ensure efficient and effective delivery. The other choices - Change agent, Educator, and Coordinator - do not directly align with the decision-making process related to staffing and resource management as seen in the scenario.

When assessing an ethical issue, the nurse must first:

  • A. ask, "What is the issue?"
  • B. identify all possible alternatives.
  • C. select the best option from a list of alternatives.
  • D. justify the choice of action or inaction.
Correct Answer: A

Rationale: The correct answer is A because before addressing any ethical issue, it is vital to first identify and define the issue clearly. This helps in understanding the context and scope of the problem. Without knowing the specific ethical issue at hand, it is impossible to proceed with identifying alternatives, selecting the best option, or justifying the choice of action. Therefore, asking "What is the issue?" is the initial step in the ethical decision-making process.

Summary:
- Option B is incorrect because identifying alternatives comes after defining the issue.
- Option C is incorrect as selecting the best option should be based on a clear understanding of the issue.
- Option D is incorrect as justifying actions or inactions should come after determining the ethical problem.

A group of nurses is presenting the importance of high-quality care during a system- wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm that:

  • A. being insured has little effect on a person's longevity and the quality of care received.
  • B. lobbyists for the drug companies are able to gain permission for the use of new drugs within 1 year of their discovery.
  • C. although a greater number of lawsuits stem from medication errors, more people actually die from human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS).
  • D. medication-related errors place a tremendous financial burden on the U.S. health care system.
Correct Answer: D

Rationale: The correct answer is D: medication-related errors place a tremendous financial burden on the U.S. health care system. This answer is correct because medication errors contribute significantly to healthcare costs due to increased hospitalizations, prolonged treatments, and legal expenses. The Quality Chasm report highlights the economic impact of medication errors on the healthcare system, emphasizing the need for improved medication safety practices.

Option A is incorrect because being insured does have a positive impact on a person's access to healthcare services and quality of care. Option B is incorrect as it does not relate to the Quality Chasm findings. Option C is incorrect as it focuses on the comparison of lawsuits and mortality rates related to medication errors and HIV/AIDS, which is not the primary focus of the Quality Chasm report.

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