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The nurse, in collaboration with the patients family, is determining priorities related to the care of the patient. The nurse explains that it is important to consider the urgency of specific problems when setting priorities. What provides the best framework for prioritizing patient problems?
- A. Availability of hospital resources
- B. Family member statements
- C. Maslows hierarchy of needs
- D. The nurses skill set
Correct Answer: C
Rationale: Maslows hierarchy of needs provides a useful framework for prioritizing problems, with the first level given to meeting physical needs of the patient. Availability of hospital resources, family member statements, and nursing skill do not provide a framework for prioritization of patient problems, though each may be considered.
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A nurse has begun creating a patients plan of care shortly after the patients admission. It is important that the wording of the chosen nursing diagnoses falls within the taxonomy of nursing. Which organization is responsible for developing the taxonomy of a nursing diagnosis?
- A. American Nurses Association (ANA)
- B. NANDA
- C. National League for Nursing (NLN)
- D. Joint Commission
Correct Answer: B
Rationale: NANDA International is the official organization responsible for developing the taxonomy of nursing diagnoses and formulating nursing diagnoses acceptable for study. The ANA, NLN, and Joint Commission are not charged with the task of developing the taxonomy of nursing diagnoses.
A care conference has been organized for a patient with complex medical and psychosocial needs. When applying the principles of critical thinking to this patients care planning, the nurse should most exemplify what characteristic?
- A. Willingness to observe behaviors
- B. A desire to utilize the nursing scope of practice fully
- C. An ability to base decisions on what has happened in the past
- D. Openness to various viewpoints
Correct Answer: D
Rationale: Willingness and openness to various viewpoints are inherent in critical thinking; these allow the nurse to reflect on the current situation. An emphasis on the past, willingness to observe behaviors, and a desire to utilize the nursing scope of practice fully are not central characteristics of critical thinkers.
An audit of a large, university medical center reveals that four patients in the hospital have current orders for restraints. You know that restraints are an intervention of last resort, and that it is inappropriate to apply restraints to which of the following patients?
- A. A postlaryngectomy patient who is attempting to pull out his tracheostomy tube
- B. A patient in hypovolemic shock trying to remove the dressing over his central venous catheter
- C. A patient with urosepsis who is ringing the call bell incessantly to use the bedside commode
- D. A patient with depression who has just tried to commit suicide and whose medications are not achieving adequate symptom control
Correct Answer: C
Rationale: Restraints should never be applied for staff convenience. The patient with urosepsis who is frequently ringing the call bell is requesting assistance to the bedside commode; this is appropriate behavior that will not result in patient harm. The other described situations could plausibly result in patient harm; therefore, it is more likely appropriate to apply restraints in these instances.
The nurse has just taken report on a newly admitted patient who is a 15 year-old girl who is a recent immigrant to the United States. When planning interventions for this patient, the nurse knows the interventions must be which of the following?
- A. Appropriate to the nurses preferences
- B. Appropriate to the patients age
- C. Ethical
- D. Appropriate to the patients culture
- E. Applicable to others with the same diagnosis
Correct Answer: B,C,D
Rationale: Planned interventions should be ethical and appropriate to the patients culture, age, and gender. Planned interventions do not have to be in alignment with the nurses preferences nor do they have to be shared by everyone with the same diagnosis.
The physician has recommended an amniocentesis for an 18-year-old primiparous woman. The patient is 34 weeks gestation and does not want this procedure. The physician is insistent the patient have the procedure. The physician arranges for the amniocentesis to be performed. The nurse should recognize that the physician is in violation of what ethical principle?
- A. Veracity
- B. Beneficence
- C. Nonmaleficence
- D. Autonomy
Correct Answer: D
Rationale: The principle of autonomy specifies that individuals have the ability to make a choice free from external constraints. The physicians actions in this case violate this principle. This action may or may not violate the principle of beneficence. Veracity centers on truth-telling and nonmaleficence is avoiding the infliction of harm.