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The nurse serves as a witness to a client giving informed consent to the primary healthcare provider (PHCP). The nurse understands that by a client giving consent this respects the client's
- A. beneficence.
- B. autonomy.
- C. nonmaleficence.
- D. confidentiality.
Correct Answer: B
Rationale: Informed consent respects client autonomy (B), allowing self-determination in medical decisions, per ethical principles. Beneficence (A) promotes well-being, nonmaleficence (C) avoids harm, and confidentiality (D) protects information, but autonomy is central to consent.
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The nurse cares for an infant undergoing a surgical repair of a total anomalous pulmonary venous return tomorrow. The doctor has talked to the parents and obtained consent. The mother tells the nurse, 'I'm not so sure about this. What if my baby dies?' The nurse's most appropriate response is:
- A. Explain the procedure to the mother.
- B. Notify the surgical team and have them come back to speak with the mother again.
- C. Reassure the mother that everything will go as planned.
- D. Tell the mother that because she has already signed the consent, she cannot change her mind now.
Correct Answer: B
Rationale: Notifying the surgical team (B) ensures the mother’s concerns are addressed by the provider, respecting her need for clarification. Explaining the procedure (A) is the physician’s role, false reassurance (C) is inappropriate, and stating consent is irrevocable (D) is incorrect and dismissive.
The nurse has received the following information about assigned clients. The nurse should first assess the client with
- A. pancreatitis who has developed bruising around the umbilicus.
- B. a capillary blood glucose of 159 mg/dL (8.83 mmol/L) [70-110 mg/dL; 4-6 mmol/L] while receiving total parenteral nutrition.
- C. a blood pressure of 156/92 mmHg who sustained an ischemic stroke six hours ago.
- D. stable angina reporting headache while receiving nitroglycerin via transdermal patch.
Correct Answer: A
Rationale: Umbilical bruising in pancreatitis (A) suggests Cullen’s sign, indicating possible retroperitoneal hemorrhage, a life-threatening emergency. Mild hyperglycemia (B), elevated BP post-stroke (C), and nitroglycerin headache (D) are less urgent, as they are expected or manageable.
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.
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 manager is conducting a staff in-service and announces that the staff nurses may decide when to take meal breaks, and the assignment for new admissions may be decided upon themselves. The nurse manager is demonstrating
- A. authoritative leadership style.
- B. democratic leadership style.
- C. participative leadership style.
- D. laissez-faire leadership style.
Correct Answer: D
Rationale: Allowing staff to decide meal breaks and assignments (D) reflects a laissez-faire leadership style, characterized by minimal direction and high autonomy. Authoritative (A) is directive, democratic/participative (B, C) involve shared decision-making but with more guidance.