Nokea
The nurse is providing care for a patient with chronic obstructive pulmonary disease (COPD). The nurses most recent assessment reveals an SaO2 of 89%. The nurse is aware that part of critical thinking is determining the significance of data that have been gathered. What characteristic of critical thinking is used in determining the best response to this assessment finding?
- A. Extrapolation
- B. Inference
- C. Characterization
- D. Interpretation
Correct Answer: D
Rationale: Nurses use interpretation to determine the significance of data that are gathered. This specific process is not described as extrapolation, inference, or characterization.
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While receiving report on a group of patients, the nurse learns that a patient with terminal cancer has granted power of attorney for health care to her brother. How does this affect the course of the patients care?
- A. Another individual has been identified to make decisions on behalf of the patient.
- B. There are binding parameters for care even if the patient changes her mind.
- C. The named individual is in charge of the patients finances.
- D. There is a document delegating custody of children to other than her spouse.
Correct Answer: A
Rationale: A power of attorney is said to be in effect when a patient has identified another individual to make decisions on her behalf. The patient has the right to change her mind. A power-of-attorney for health care does not give anyone the right to make financial decisions for the patient nor does it delegate custody of minor children.
A nurse has been offered a position on an obstetric unit and has learned that the unit offers therapeutic abortions, a procedure which contradicts the nurses personal beliefs. What is the nurses ethical obligation to these patients?
- A. The nurse should adhere to professional standards of practice and offer service to these patients.
- B. The nurse should make the choice to decline this position and pursue a different nursing role.
- C. The nurse should decline to care for the patients considering abortion.
- D. The nurse should express alternatives to women considering terminating their pregnancy.
Correct Answer: B
Rationale: To avoid facing ethical dilemmas, nurses can follow certain strategies. For example, when applying for a job, a nurse should ask questions regarding the patient population. If a nurse is uncomfortable with a particular situation, then not accepting the position would be the best option. The nurse is only required by law (and practice standards) to provide care to the patients the clinic accepts; the nurse may not discriminate between patients and the nurse expressing his or her own opinion and providing another option is inappropriate.
You are the nurse who is caring for a patient with a newly diagnosed allergy to peanuts. Which of the following is an immediate goal that is most relevant to a nursing diagnosis of deficient knowledge related to appropriate use of an EpiPen?
- A. The patient will demonstrate correct injection technique with todays teaching session.
- B. The patient will closely observe the nurse demonstrating the injection.
- C. The nurse will teach the patients family member to administer the injection.
- D. The patient will return to the clinic within 2 weeks to demonstrate the injection.
Correct Answer: A
Rationale: Immediate goals are those that can be reached in a short period of time. An appropriate immediate goal for this patient is that the patient will demonstrate correct administration of the medication today. The goal should specify that the patient administer the EpiPen. A 2-week time frame is inconsistent with an immediate goal.
During discussion with the patient and the patients husband, you discover that the patient has a living will. How does the presence of a living will influence the patients care?
- A. The patient is legally unable to refuse basic life support.
- B. The physician can override the patients desires for treatment if desires are not evidence-based.
- C. The patient may nullify the living will during her hospitalization if she chooses to do so.
- D. Power-of-attorney may change while the patient is hospitalized.
Correct Answer: C
Rationale: Because living wills are often written when the person is in good health, it is not unusual for the patient to nullify the living will during illness. A living will does not make a patient legally unable to refuse basic life support. The physician may disagree with the patients wishes, but he or she is ethically bound to carry out those wishes. A power-of-attorney is not synonymous with a living will.
Your older adult patient has a diagnosis of rheumatoid arthritis (RA) and has been achieving only modest relief of her symptoms with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). When creating this patients plan of care, which nursing diagnosis would most likely be appropriate?
- A. Self-care deficit related to fatigue and joint stiffness
- B. Ineffective airway clearance related to chronic pain
- C. Risk for hopelessness related to body image disturbance
- D. Anxiety related to chronic joint pain
Correct Answer: A
Rationale: Nursing diagnoses are actual or potential problems that can be managed by independent nursing actions. Self-care deficit would be the most likely consequence of rheumatoid arthritis. Anxiety and hopelessness are plausible consequences of a chronic illness such as RA, but challenges with self-care are more likely. Ineffective airway clearance is unlikely.