Nokea
The nurse has attended a staff education program about ethical practices in nursing. Which of the following statements by the nurse would indicate a correct understanding of the program? Select all that apply.
- A. Accountability is notifying the health care provider after making a medication error.
- B. Autonomy is informing the client of the care decisions the family has made for the client.
- C. Confidentiality is respecting a client's request to keep suicidal ideation a secret from other members of the health care team.
- D. Fidelity is returning to the client's room with pain medication at the time that was promised to the client.
- E. Nonmaleficence is reporting suspected elder abuse of a client with Alzheimer disease.
Correct Answer: A,D,E
Rationale: Accountability involves taking responsibility for errors (A). Fidelity is keeping promises, such as timely medication delivery (D). Nonmaleficence includes preventing harm by reporting abuse (E). Autonomy respects the client's decision-making, not family decisions (B), and confidentiality does not extend to withholding suicidal ideation, which requires intervention (C).
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A couple from the Philippines living in the United States is expecting their first child. In providing culturally competent care, the nurse must first:
- A. review their own cultural beliefs and biases.
- B. respectfully request that the couple utilize only medically approved health care providers.
- C. realize that the clients have to learn their new country's accepted medical practices.
- D. study family dynamics to understand the male and female gender roles in the clients' culture.
Correct Answer: A
Rationale: Self-awareness of the nurse's own cultural biases is the first step in providing culturally competent care, ensuring nonjudgmental interactions. The other actions are secondary or prescriptive. Psychosocial Integrity
The client screams at the nurse, 'You are all incompetent here! I have been waiting for 2 hours!' How should the nurse respond initially?
- A. I know you are upset, but I will have to call security if you continue to scream.
- B. I see that you are frustrated, but the delay cannot be avoided.
- C. It is upsetting to wait so long. How can I best help you?
- D. The wait is long today, but you will receive quality, unhurried care when it is your turn.
Correct Answer: C
Rationale: Acknowledging the client's frustration and offering assistance de-escalates the situation and focuses on solutions. Threatening security escalates tension, and the other options dismiss the client's feelings or fail to address the issue.
A client addicted to morphine is being treated for withdrawal symptoms. The drug commonly administered for opiate withdrawal is:
- A. Tranxene (chlorazepate)
- B. Suboxone (buprenorphine, naloxone)
- C. Narcan (naloxone)
- D. Antabuse (disulfiram)
Correct Answer: B
Rationale: Suboxone is commonly used for opiate withdrawal as it reduces withdrawal symptoms and cravings. Answer A is a benzodiazepine, Answer C is for overdose reversal, and Answer D is for alcohol dependence, so they are incorrect.
The role of the incident report in risk management is:
- A. liability protection.
- B. to provide data for analysis by a risk manager to determine how future problems can be avoided.
- C. to discipline staff for errors.
- D. all of the above.
Correct Answer: B
Rationale: Incident reports collect data to analyze and prevent future issues, enhancing safety. They are not for liability protection or staff discipline. Safety and Infection Control
A 15-year-old client with iron deficiency anemia and a ruptured ectopic pregnancy needs a blood transfusion prior to surgery. The client's mother is a Jehovah's Witness and refuses to sign the blood permit. Which nursing action is most appropriate?
- A. Give the blood without the mother's permission.
- B. Coax the mother to change her mind.
- C. Allow the client to sign the permit.
- D. Notify the physician of the mother's refusal.
Correct Answer: D
Rationale: The nurse must respect the mother's refusal due to religious beliefs and notify the physician to discuss alternatives or legal options, such as court intervention for a minor in a life-threatening situation. Giving blood without permission is unethical and illegal. Coaxing may be coercive, and a 15-year-old typically cannot provide legal consent.