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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 steps in which order. Put a comma and space between each answer choice (e.g., a, b, c, d).
- A. Open inner package, taking care not to touch inner surface.
- B. Put the glove on the nondominant hand using the sterile gloved hand.
- C. Put glove on dominant hand by grasping folded cuff edge, touching only inside of cuff.
- D. Adjust each glove carefully by sliding finders under the cuff.
Correct Answer: A
Rationale: The correct order is to first open the outer package to access the inner package containing the gloves. This ensures that the gloves remain sterile until they are needed. Opening the inner package first would expose the gloves to potential contamination. Putting on the gloves should be done after opening the inner package, starting with the nondominant hand to prevent contamination. Adjusting the gloves carefully should be the final step after both gloves are on to ensure a proper fit. Therefore, choice A is correct as it establishes the correct sequence for maintaining sterility throughout the process.
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Nurses on a busy medical schedule want to reduce documentation time and improve order entry. Additionally, patient records from previous visits are often incomplete or do not include care from other providers. To improve patient care, a taskforce suggests using an Electronic Medical Record for 1 month to determine whether this provides the desired outcomes. This unit is participating in which type of study?
- A. Ethnography
- B. Pilot
- C. Secondary data analysis
- D. Phenomenology
Correct Answer: B
Rationale: The correct answer is B: Pilot. A pilot study involves testing a new intervention on a small scale to assess feasibility and potential outcomes before implementing it on a larger scale. In this case, the unit is planning to use an Electronic Medical Record for a limited time to evaluate its impact on documentation time and patient care. This approach allows for targeted feedback and adjustments based on the outcomes observed during the trial period.
A: Ethnography involves in-depth observation and analysis of a specific culture or group, which is not the focus of the scenario.
C: Secondary data analysis involves the use of existing data for research purposes, not the implementation of a new intervention.
D: Phenomenology focuses on understanding individuals' subjective experiences, which is not the primary goal of implementing an Electronic Medical Record in this case.
A nurse who functions in the role of team leader can be held negligent for matters involving:
- A. inadequate training.
- B. lack of development of proper policies and procedures.
- C. failure to discipline unsafe workers.
- D. delegation of client care tasks.
Correct Answer: D
Rationale: The correct answer is D: delegation of client care tasks. A team leader nurse can be held negligent for improper delegation as they are responsible for assigning tasks to appropriate staff ensuring safe and effective care. This is crucial for patient safety. Choices A, B, and C are incorrect because inadequate training, lack of policies, and failure to discipline unsafe workers are not directly related to the nurse's role in delegation and immediate patient care responsibilities.
The task of completing and signing the initial assessment on a newly admitted patient who is about to undergo minimally invasive procedures on an outpatient basis can be delegated to:
- A. the registered nurse (RN).
- B. the licensed practical/vocational nurse (LPN/LVN).
- C. unlicensed assistive personnel (UAP).
- D. all levels of staff, because the information is about the past and cannot change.
Correct Answer: A
Rationale: The correct answer is A: the registered nurse (RN). This task requires clinical judgment and critical thinking skills, which are within the scope of practice of an RN. The RN is trained to assess the patient comprehensively, identify potential risks, and communicate effectively with other healthcare team members. LPNs/LVNs may not have the same level of assessment skills as RNs. UAPs do not have the clinical knowledge or skills required for this task. Option D is incorrect as completing and signing the initial assessment requires active patient assessment, which is a dynamic process and not just about past information.
In February 2010, Congress passed legislation to support universal health care for all Americans. At a local health fair, an individual asks about the difference between universal health care and a single payer system. The nurse explains the difference is that:
- A. with universal health, one universal payer, usually the government, pays all expenses for health care.
- B. single-payer systems offer health care only to eligible persons based on income.
- C. single-payer systems rely on insurance companies to pay predetermined fees for services.
- D. with universal health, one payer is responsible for all health care costs, providing health care to all citizens.
Correct Answer: A
Rationale: The correct answer is A because in a universal health care system, one universal payer (often the government) is responsible for covering all health care expenses for all citizens. This means that everyone, regardless of income or eligibility, is covered under the same system.
Choice B is incorrect because a single-payer system does not necessarily limit health care access based on income; it simply means there is one entity responsible for paying health care costs.
Choice C is incorrect because single-payer systems do not rely on insurance companies to pay fees; instead, the single payer itself covers the costs directly.
Choice D is incorrect because it does not specify that the one payer in a universal health care system is usually the government, which is a key distinction in this context.
The Health Care Reform Act provides insurance for all U.S. citizens and legal residents presenting far-reaching ethical considerations related to diverse individual patient health care beliefs for those delivering nursing care. Nurses must consider their civil rights under the rights of conscience and how new health care agendas such as the Patient Protection and Affordable Care Act (PPACA) could affect their practice in situations that may conflict with their own belief system. Today's practicing nurse must:
- A. remember it is one's professional duty to render patient-centered care"even when it is in direct conflict with the nurse's own beliefs"or be held liable for withholding treatment.
- B. consider whether the right to act according to one's inner beliefs will continue to be permissible when federal health insurance becomes fully enacted.
- C. discuss with the patient and family different options in hopes they will accept the nurse's health care beliefs.
- D. suggest to the hospital administration that they not accept federal funding to prevent controversial health practices.
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct:
1. Professional duty: Nurses have a duty to provide patient-centered care regardless of personal beliefs.
2. Legal liability: Withholding treatment based on personal beliefs can lead to legal consequences.
3. Ethical considerations: Nurses must prioritize patient care over personal beliefs.
4. Rights of conscience: Nurses may have the right to refuse to participate in certain treatments, but they must still ensure patient care.
5. Patient-centered care: Nurses must respect patient autonomy and provide care based on the patient's wishes.
Summary of why the other choices are incorrect:
B. Irrelevant to the nurse's duty to provide patient-centered care.
C. Nurses should not impose their beliefs on patients but should respect and support their choices.
D. Suggesting the hospital not accept federal funding does not address the nurse's duty to provide patient-centered care.