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Two hospitalized patients resort to physical fighting when they are in the same room. During a team meeting, a nurse asserts that safety is of paramount importance and therefore the treatment plans should call for both patients to be secluded to prevent them from injuring each other. Which does this assertion indicate about the nurse who presented it?
- A. Reveals that the nurse has a strong sense of justice.
- B. Values the reinforcement of the autonomy of the two patients.
- C. Has a poor understanding of the civil rights of the two patients.
- D. Doesn't understand the actions that constitute the intentional tort of battery.
Correct Answer: C
Rationale: The nurse's suggestion of seclusion ignores the right to the least restrictive treatment, indicating a poor understanding of civil rights. Seclusion removes autonomy, is motivated by beneficence, not justice, and risks false imprisonment, not battery.
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A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse is obligated to take what action?
- A. Implement the order as written but document the concern.
- B. Hold the medication and then notify the health care provider.
- C. Consult a drug reference if a pharmacist is not available.
- D. Give the usual geriatric dosage at the scheduled times.
Correct Answer: B
Rationale: Holding the medication and consulting the provider protects the patient, as geriatric doses are typically lower.
Which situations qualify as abandonment on the part of a nurse?
- A. The nurse allows a patient with acute mania to refuse hospitalization without taking further action.
- B. The nurse terminates employment without referring a seriously mentally ill patient for aftercare.
- C. The nurse calls police to bring a suicidal patient to the hospital after a suicide attempt.
- D. The nurse refers a patient with persistent paranoid schizophrenia to community treatment.
- E. The nurse asks another nurse to provide a patient's care because of concerns about countertransference.
Correct Answer: A,B
Rationale: Failing to ensure continued care for acutely ill patients constitutes abandonment. Other actions provide for patient safety or self-awareness.
After leaving work, a staff nurse realizes that documentation of the administration of a medication to a patient was omitted. This off-duty nurse telephones the unit and tells the nurse, 'Please document the administration of the medication I forgot to do. My password is alphal.' What action should the on-duty nurse take?
- A. Suggest the nurse return and document.
- B. Refer the matter to the charge nurse to resolve.
- C. Access the record and document the information.
- D. Report the request to the patient's health care provider.
Correct Answer: B
Rationale: Referring to the charge nurse ensures policy compliance and proper documentation without risking unauthorized access.
Which documentation of a patient's behavior best demonstrates a nurse's observations?
- A. Isolates self from others. Frequently fell asleep during group. Vital signs stable.
- B. Calmer and more cooperative. Participated actively in group. No evidence of psychotic thinking.
- C. Appeared to hallucinate. Patient frequently increased volume on television, causing conflict with others
- D. Wears four layers of clothing. States, 'I need protection from dangerous bacteria trying to penetrate my skin.'
Correct Answer: D
Rationale: Specific observations and direct quotes provide clear, objective documentation, unlike vague or subjective options.
A voluntarily hospitalized patient tells the nurse, 'Get me the forms I need to sign so I can leave this place now.' What is the nurse's best initial response?
- A. I can't give you those forms without your health care provider's knowledge.'
- B. I will get them for you, but let's talk about your decision to leave treatment.'
- C. Since you signed your consent for treatment, you may leave if you desire.'
- D. I'll get the forms for you right now and bring them to your room.'
Correct Answer: B
Rationale: Discussing the decision respects patient rights while advocating for their best interests. Immediate discharge without exploration may neglect underlying issues.