Contemporary Issues in Nursing

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The number of IV site infections has more than doubled on a nursing unit. The staff determine common causes include the site is cleaned using inconsistent methods, dressing frequently becomes wet when patient showers, IV tubing is not changed every 48 hours per protocol, and inadequate hand washing of RN prior to insertion. A bar graph demonstrates the frequency in descending order, with 80% of infections being attributed to inadequate hand washing. The quality tool used is a:

  • A. cause-and-effect diagram.
  • B. run chart.
  • C. Pareto chart.
  • D. flowchart.
Correct Answer: C

Rationale: The correct answer is C: Pareto chart. A Pareto chart is a quality tool used to prioritize issues by identifying the most significant factors contributing to a problem. In this case, the Pareto chart is appropriate because it helps visually show that inadequate hand washing is the primary cause of IV site infections, as it accounts for 80% of all infections. The chart allows the staff to focus their efforts on addressing this key issue first, which is crucial for effectively reducing the overall infection rate.

Incorrect choices:
A: Cause-and-effect diagram - This tool is used to identify and analyze potential causes of a problem, but it does not prioritize them in the same way a Pareto chart does.
B: Run chart - A run chart is used to track data over time to identify trends and patterns, but it does not prioritize the causes of a problem like a Pareto chart.
D: Flowchart - Flowcharts are used to map out a process or workflow, but they do not prioritize issues

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A Southeast Asian woman brings her baby into the clinic because the baby is lethargic. The nurse determines that the baby has had diarrhea and vomiting for several days, resulting in dehydration. Physical examination reveals small, round burns on the abdomen. These burns probably are the result of cigarettes or burning cotton used to:

  • A. try to quiet the child and is considered child abuse.
  • B. bring out toxic wind from the body.
  • C. balance heat loss from the body.
  • D. brush the body with ruda to allow spirits to return.
Correct Answer: A

Rationale: The correct answer is A: try to quiet the child and is considered child abuse. The small, round burns on the baby's abdomen are likely caused by cigarettes or burning cotton as a form of child abuse known as "cigarette burns." This type of abuse is characterized by deliberately causing harm to a child by burning them with cigarettes or other hot objects. The other choices (B, C, D) are incorrect as they do not address the intentional harm and abuse inflicted upon the child in this scenario. Choice B about bringing out toxic wind is not a valid cultural or medical practice and is not relevant in this context. Choice C about balancing heat loss is not related to the burns observed. Choice D about brushing the body with ruda for spirits to return is not a known or appropriate intervention for addressing burns or abuse.

A bill is pending in the state legislature that will mandate teaching health promotion related to smoking cessation. Which action by the nurse should have the greatest impact on passage of the bill?

  • A. Explain the rationale for the bill to the school board.
  • B. Contact the elected representative's office by telephone to request support for the bill.
  • C. Support a health advocate to run for election as state representative.
  • D. Tell all students about the bill.
Correct Answer: B

Rationale: The correct answer is B: Contact the elected representative's office by telephone to request support for the bill. This action is the most direct and effective way to influence the passage of the bill. By directly contacting the elected representative, the nurse can advocate for the importance of the bill and provide relevant information to garner their support. This direct communication with the decision-maker holds significant weight in influencing their vote on the bill.

A: Explaining the rationale to the school board may be informative, but the school board may not have direct influence on the state legislature.
C: Supporting a health advocate to run for election is a long-term strategy and may not have an immediate impact on the passage of the bill.
D: Telling all students about the bill may raise awareness but may not directly influence the lawmakers' decisions.

A nursing student planning to apply for licensure knows that being charged with which offense would result in a minor criminal offense?

  • A. Solicitation of illegal drugs
  • B. Stealing a car
  • C. Failing to report elder abuse
  • D. Billing Medicare for services not rendered
Correct Answer: A

Rationale: The correct answer is A: Solicitation of illegal drugs. This offense typically results in a minor criminal offense because it involves attempting to purchase or obtain illegal drugs, which is considered a less serious crime compared to the other choices. Stealing a car (B) is a major criminal offense, as it involves theft of property. Failing to report elder abuse (C) is a serious offense as it neglects the duty to protect vulnerable individuals. Billing Medicare for services not rendered (D) is a form of fraud and can result in severe consequences. Therefore, the solicitation of illegal drugs is the least serious offense among the options provided.

A nurse investigates energy therapies and learns that which therapies would be included? (select all that apply)

  • A. Qi gong
  • B. Osteopathy
  • C. Imagery
  • D. Healing touch
Correct Answer: A

Rationale: The correct answer is A: Qi gong. Qi gong is a form of energy therapy that focuses on balancing the body's energy flow. It involves gentle movements, meditation, and breathing exercises to promote healing and overall well-being. Osteopathy (B) is a manual therapy focusing on physical manipulation of the body, not energy. Imagery (C) involves mental visualization, not energy manipulation. Healing touch (D) is a form of energy therapy, but Qi gong is a more widely recognized and specific example in this context.

Which types of abuse are the nurse required to report or be subject to fines and imprisonment for not reporting? (select all that apply)

  • A. Animal
  • B. Child
  • C. Alcohol
  • D. Infant
Correct Answer: B

Rationale: The correct answer is B: Child abuse. Nurses are mandated reporters of child abuse, meaning they are legally required to report any suspected or witnessed cases to the appropriate authorities. Failure to report can result in fines and imprisonment. Child abuse is a serious issue that requires immediate intervention to protect the safety and well-being of the child.

Explanation for incorrect choices:
A: Animal abuse - While animal abuse is also a serious concern, nurses are not legally required to report it in the same way as child abuse.
C: Alcohol abuse - Nurses may provide assistance and support for individuals struggling with alcohol abuse, but it is not a mandatory reporting requirement.
D: Infant abuse - While abuse of infants falls under the category of child abuse, the specific term "infant abuse" is not a separate reporting requirement for nurses.

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