Ethics and Issues in Contemporary Nursing

Ethics and Issues in Contemporary Nursing Related

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The nurse prepares to apply sterile gloves needed for a procedure. After introducing self and verifying patient information, the nurse performs hand hygiene. The nurse should open the outer package and then perform the following steps in order: (items on left will be moved in correct order on the right) Open inner package, taking care not to touch inner surface. Put the glove on the nondominant hand using the sterile gloved hand. Put glove on dominant hand by grasping folded cuff edge, touching only inside of cuff. Adjust each glove carefully by sliding finders under the cuffs. The above question represents which type of alternate-format question written at which level of Bloom's taxonomy?

  • A. Drag-and-drop item, comprehension
  • B. Chart/exhibit item, analysis
  • C. Multiple-response, application
  • D. Hot-spot item, knowledge
Correct Answer: A

Rationale: The correct answer is A: Drag-and-drop item, comprehension. This question requires the nurse to demonstrate understanding of the correct sequence for applying sterile gloves. The drag-and-drop format assesses the ability to organize steps in a specific order, which falls under the comprehension level of Bloom's taxonomy, where the individual is required to understand the information provided. The other choices are incorrect because:
B: Chart/exhibit item, analysis - This choice involves interpreting data or information presented in a chart or exhibit, which is not the case in this question.
C: Multiple-response, application - This choice requires selecting multiple correct responses to a scenario, which is not the format of this question.
D: Hot-spot item, knowledge - This choice involves identifying a specific area or point on an image, which is not relevant to the question about the correct sequence for applying sterile gloves.

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When first diagnosed with Parkinson disease, how can the patient and family best avoid future ethical dilemmas concerning the patient's care?

  • A. Work with the patient and family to create an advanced plan of care.
  • B. Explain to the family that the patient's cognitive function will deteriorate as time passes.
  • C. Discuss the patient's religious and spiritual concerns to identify potential problems.
  • D. Identify which family members will be in control of decision making for the patient.
Correct Answer: A

Rationale: The correct answer is A: Work with the patient and family to create an advanced plan of care. This is the best way to avoid ethical dilemmas because it involves proactive decision-making and communication among all parties involved. By creating an advanced plan of care, the patient and family can outline the patient's preferences, values, and goals for future care, ensuring that decisions align with the patient's wishes. This helps prevent potential conflicts and ensures that everyone is on the same page regarding the patient's care.

Choices B, C, and D are incorrect:
B: Explaining cognitive decline does not directly address how to avoid ethical dilemmas and may cause unnecessary distress.
C: Discussing religious and spiritual concerns is important but may not specifically address future ethical dilemmas related to care decisions.
D: Identifying family members in control of decision-making does not necessarily prevent ethical dilemmas and may overlook the patient's autonomy and preferences.

A nurse plans to move to an area that is rich in immigrants from several countries and is concerned about respecting others' cultural beliefs. The nurse's first step to ensure cultural competence and sensitivity is to:

  • A. enroll in a nursing theories course to increase knowledge about transcultural practices.
  • B. become immersed in nursing literature about culturally diverse clients.
  • C. participate in continuing education that focuses on health assessment variations among cultural groups.
  • D. conduct a cultural self-assessment.
Correct Answer: D

Rationale: The correct answer is D: conduct a cultural self-assessment. This is the first step to ensure cultural competence because it allows the nurse to reflect on their own beliefs, biases, and cultural background, which can impact interactions with culturally diverse clients. By understanding one's own cultural identity, the nurse can better appreciate and respect the beliefs of others.

Choice A is incorrect because enrolling in a nursing theories course may provide knowledge but does not address the nurse's own biases. Choice B is also incorrect as immersion in nursing literature may increase knowledge but does not promote self-awareness. Choice C is incorrect as focusing on health assessment variations does not necessarily address cultural sensitivity in interactions. Conducting a cultural self-assessment is essential for building a foundation of cultural competence and respect.

A nurse manager is working with the financial officer to develop the budget of the nursing unit for the next fiscal year. The nurse manager tells the financial officer that which of the following pieces of information will affect budget assumptions?

  • A. The capital budget request for new emergency department equipment has been turned in for consideration by the hospital's administrative team.
  • B. The patient census likely will increase during the next fiscal year because two large physician groups have transferred their admission privileges to this hospital.
  • C. The participatory budgeting approach instituted last year has been helpful in controlling supply costs.
  • D. Zero-based budgeting will help the managers to be more efficient in establishing next year's budget.
Correct Answer: B

Rationale: The correct answer is B because an increase in patient census directly impacts the budget assumptions by affecting staffing needs, supply costs, and revenue projections. This information is crucial for accurate budget planning.
Choice A is incorrect because the capital budget request for new equipment does not directly impact the nursing unit's operational budget assumptions.
Choice C is incorrect as the effectiveness of participatory budgeting in controlling supply costs does not directly influence future budget assumptions.
Choice D is incorrect as zero-based budgeting efficiency does not directly address the impact of increased patient census on budget assumptions.

A patient with complicated diabetes is scheduled for a below the knee amputation at 7 AM. The surgical team adheres to the 2012 National Patient Safety Goals by implementing which protocols? (select all that apply)

  • A. The surgical team asks the patient to verify his or her name, type of surgery, and limb to be removed.
  • B. Ask each member of the surgical team to provide a copy of licensure and, if applicable, certification to patient and family.
  • C. The surgical team uses the chart number and name/hospital number to ensure they have the correct patient.
  • D. Mark the procedure site with "X" and again ask the patient to verify correct site.
Correct Answer: A

Rationale: The correct answer is A because it aligns with the 2012 National Patient Safety Goals, specifically the goal of improving the accuracy of patient identification. By asking the patient to confirm their name, type of surgery, and limb to be removed, the surgical team is ensuring that they have the correct patient and are performing the correct procedure. This protocol helps prevent errors and ensures patient safety.

Option B is incorrect because asking for licensure and certification does not directly relate to patient safety or accurate patient identification.

Option C is incorrect because relying solely on chart numbers or hospital numbers may not be sufficient to prevent errors in patient identification.

Option D is incorrect because while marking the procedure site is important, relying solely on the patient to verify the correct site may not be as effective as having the healthcare team confirm this information with the patient.

A nurse tallies the patient satisfaction surveys and approves the use of an agency nurse because of the high census. This nurse is involved in which nursing role?

  • A. Change agent
  • B. Educator
  • C. Manager
  • D. Coordinator
Correct Answer: C

Rationale: The correct answer is C: Manager. In this scenario, the nurse is making decisions related to staffing and resource management based on patient census, which falls under the responsibilities of a nurse manager. A manager oversees the organization and coordination of nursing care to ensure efficient and effective delivery. The other choices - Change agent, Educator, and Coordinator - do not directly align with the decision-making process related to staffing and resource management as seen in the scenario.

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