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The nurse observes another nurse starting their shift under the influence of alcohol and decides not to report the nurse to the supervisor. Which ethical principle is the nurse violating?
- A. Confidentiality
- B. Nonmaleficence
- C. Justice
- D. Beneficence
Correct Answer: B
Rationale: Not reporting a nurse under the influence violates nonmaleficence (B), as it risks harm to clients due to impaired care. Confidentiality (A) is unrelated, justice (C) pertains to fairness, and beneficence (D) involves promoting good, which is secondary to preventing harm.
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A mental health clinic is being constructed in a local community. A nurse manager is hired to facilitate the unit’s nursing policies. Which of the following is the best resource for these policies?
- A. Code of Ethics
- B. Nurse Practice Act
- C. Patient’s Bill of Rights
- D. Rights for the Mentally Ill
Correct Answer: B
Rationale: The Nurse Practice Act (B) defines legal scope and standards for nursing practice, making it the best resource for policy development. Code of Ethics (A), Patient’s Bill of Rights (C), and Rights for the Mentally Ill (D) guide but lack specific operational details.
The nurse is triaging clients who were involved in a bus accident. Which client should be prioritized for transport to the local trauma center? A client who
- A. has pain and significant swelling in the right forearm with an intact distal pulse and sensation.
- B. has profuse bleeding from a chest laceration and is experiencing apnea.
- C. has a crushed leg reporting no sensation and has no distal pulse.
- D. is experiencing severe anxiety and has abrasions on both arms.
Correct Answer: B
Rationale: Profuse chest bleeding and apnea (B) indicate immediate life-threatening airway and circulation compromise, requiring trauma center transport. Forearm swelling (A), crushed leg (C), and anxiety (D) are serious but less acute, as they have intact vital signs or are stable.
The nurse is caring for a client who is asking about advanced directives. Many documents fall under the category of an advanced directive. The nurse knows that one of the most common legal papers is called 'Durable Power of Attorney for Health Care' and works to:
- A. Review a person's personal preferences for medical care in the future.
- B. Authorize another person to make medical decisions for a person if they become unable to on their own.
- C. Assign a legal authority in making medical decisions while honoring the spoken word of the family.
- D. Define what care should be administered or withheld by health care professionals, no matter which medical facility the patient finds themselves in.
Correct Answer: B
Rationale: A Durable Power of Attorney for Health Care (B) authorizes a designated person to make medical decisions if the client is incapacitated. Reviewing preferences (A) describes a living will. Honoring family wishes (C) is not legally binding, and defining care across facilities (D) overstates its scope.
The nurse is planning client care. It would be a priority for the nurse to intervene if the client with
- A. osteomyelitis receiving intravenous (IV) antibiotics has a temperature of 103.4°F (39.7°C).
- B. viral hepatitis has persistent nausea and vomiting.
- C. septic shock has a mean arterial pressure of 56 mm Hg after a saline bolus.
- D. diverticulitis reports pain 7/10 on the Numerical Rating Scale.
Correct Answer: C
Rationale: A mean arterial pressure of 56 mm Hg in septic shock (C) indicates severe hypotension and organ hypoperfusion, requiring immediate intervention. High fever in osteomyelitis (A), nausea in hepatitis (B), and pain in diverticulitis (D) are serious but less immediately life-threatening.
The nurse manager is completing an annual performance evaluation of a staff nurse. Which elements should the nurse manager include when completing the evaluation? Select all that apply.
- A. The nurses’ bar-code medication administration scan rate
- B. The number of times the nurse has been absent or tardy
- C. The nurse achieving a national certification
- D. The nurses’ performance compared to other staff nurses
- E. The number of medication errors the nurse has self-reported.
Correct Answer: A, B, C, E
Rationale: Bar-code scan rate (A), absences/tardiness (B), national certification (C), and self-reported errors (E) are objective metrics for evaluation. Comparing to other nurses (D) is subjective and biased, inappropriate for inclusion.