Nokea
The nurse employed in a home health agency is religiously opposed to homosexuality and cannot care for a client diagnosed with human immunodeficiency virus (HIV). The nurse then leaves the client's home. Which statement accurately identifies the nurse's rights and actions? Select all that apply.
- A. The nurse has the moral right to leave the client's home at any time.
- B. The nurse has a legal right to inform the client of any barriers to providing care.
- C. The nurse has a duty to protect self from client care situations that are morally repellent.
- D. The nurse has a duty to provide competent care to assigned clients in a nondiscriminatory manner.
- E. The nurse has the right to refuse to care for any client on religious grounds if competent care coverage is arranged.
Correct Answer: D,E
Rationale: The nurse has a duty to provide care to all clients in a nondiscriminatory manner. Personal autonomy does not apply if it interferes with the rights of the client. Refusal to provide care may be acceptable if that refusal does not put the client's safety at risk and the refusal is primarily associated with religious objections, not personal objection, to lifestyle or medical diagnosis. There is no legal obligation to inform the client of the nurse's personal objections to the client. The nurse also has an obligation to observe the principle of nonmaleficence (neither causing nor allowing harm to befall the client).
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A client with a diagnosis of schizophrenia and psychosis is pacing, agitated, and presenting with aggressive gestures. The client's speech pattern is rapid, and the client's affect is belligerent. Which priority nursing intervention based on these objective data should the nurse implement?
- A. Provide safety for the client and other clients on the unit.
- B. Bring the client to a less stimulated area to regain control.
- C. Provide the clients on the unit with a sense of comfort and safety.
- D. Assist the staff in caring for the client in a controlled environment.
Correct Answer: A
Rationale: If a client is exhibiting signs that indicate loss of control, the nurse's immediate priority is to ensure safety for all clients. Option 1 is the only option that addresses the client's and other clients' safety needs. Option 2 addresses the client's needs. Option 3 addresses other clients' needs. Option 4 is not client centered.
The nurse is preparing the bedside for a postoperative parathyroidectomy client. The nurse should ensure that which specific priority item is at the client's bedside?
- A. Cardiac monitor
- B. Tracheotomy set
- C. Intermittent gastric suction
- D. Underwater seal chest drainage system
Correct Answer: B
Rationale: Respiratory distress caused by hemorrhage and swelling and compression of the trachea is a primary concern for the nurse managing the care of a postoperative parathyroidectomy client. An emergency tracheotomy set is always routinely placed at the bedside of the client with this type of surgery, in anticipation of this potential complication. Although a cardiac monitor may be attached to the client in the postoperative period, it is not specific to this type of surgery. Options 3 and 4 also are not specifically needed with the surgical procedure.
The nurse places a hospitalized client with a diagnosis of active tuberculosis in a private, well-ventilated isolation room. In addition, which action should the nurse take before entering the client's room?
- A. Wash the hands.
- B. Wash the hands and wear a gown and gloves.
- C. Wash the hands and place a high-efficiency particulate air (HEPA) respirator over the nose and mouth.
- D. The nurse needs no special precautions, but the client is instructed to cover his or her mouth and nose when coughing or sneezing.
Correct Answer: C
Rationale: Tuberculosis is a highly communicable disease caused by Mycobacterium tuberculosis. The nurse wears a HEPA respirator when caring for a client with active tuberculosis. Hands are always thoroughly washed before and after caring for the client. Option 1 is an incomplete action. Option 2 is also inaccurate and incomplete. Gowning is only indicated when there is a possibility of contaminating clothing. Option 4 is an incorrect statement because special precautions are needed.
The nurse is preparing to administer a first dose of prescribed pentamidine isethionate intravenously to a client. Before administering the dose, which safety measure should the nurse consider for this client?
- A. Assign to a private room.
- B. Establish a supine position.
- C. Place on respiratory precautions.
- D. Assist to a semi-Fowler's position.
Correct Answer: B
Rationale: Pentamidine isethionate is an antiinfective medication and can cause severe and sudden hypotension, even with administration of a single dose. The client should be lying down during administration of this medication. The blood pressure is monitored frequently during administration. Assigning to a private room, instituting respiratory precautions, or assisting to a semi-Fowler position are all unnecessary interventions.
The nurse is assigned to care for a client who is in traction. Which intervention by the nurse should ensure a safe environment for the client?
- A. Making sure that the knots are at the pulleys sites
- B. Checking the weights to be sure that they are off the floor
- C. Making sure that the head of the bed is kept at a 90-degree angle
- D. Monitoring the weights to be sure that they are resting on a firm surface
Correct Answer: B
Rationale: To achieve proper traction, weights need to be free-hanging, with knots kept away from the pulleys. The head of the bed is usually kept low to provide countertraction. Weights are not to be kept resting on a firm surface.