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When a client who is in pain refuses to be repositioned, what should the nurse consider first in making a decision about what to do?
- A. Why a decision is needed.
- B. Who actually gets to make the decision?
- C. What are the alternatives?
- D. When a decision is needed.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Understanding why a decision is needed is crucial in this situation to prioritize the client's well-being.
2. The nurse needs to assess the reasons behind the client's refusal to be repositioned, considering factors such as pain level and potential harm.
3. By determining the underlying cause, the nurse can make an informed decision on the best course of action to address the client's needs promptly.
4. Considering the alternatives (choice C) is important but secondary to understanding the urgency and necessity of the decision (choice A).
5. Who makes the decision (choice B) and when it is needed (choice D) are not as critical as the rationale behind the decision-making process.
Summary:
Choice A is correct because understanding the reason for the decision is essential for prioritizing the client's well-being. Choices B, C, and D are incorrect as they do not directly address the immediate need to assess the situation and make an informed decision based on the client's condition
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Your nurse manager talks with you once per week to determine how you are adjusting to your role as a new nurse. She asks if you feel that you are able to provide good care to your patients, whether you are becoming familiar with the electronic health record, and whether your preceptor is encouraging your independence. This manager is demonstrating:
- A. An intrusive style.
- B. An effort to understand if you are coping with the demands.
- C. An attempt to intimidate.
- D. An authoritarian style.
Correct Answer: B
Rationale: The correct answer is B because the nurse manager is showing genuine concern for the new nurse's well-being and professional development. By asking about the nurse's ability to provide care, familiarity with the EHR, and support from the preceptor, the manager is seeking to understand and support the nurse's adjustment to the new role. This approach fosters open communication and a supportive environment.
Incorrect Choices:
A: An intrusive style implies invading personal boundaries, which is not evident in the scenario.
C: Intimidation involves creating fear or anxiety, which is not reflected in the manager's behavior.
D: An authoritarian style is characterized by strict control and limited feedback, which contradicts the manager's supportive and open approach.
A nurse is considering employment at a long-term care facility that has a functional nursing delivery system. Knowing this, the nurse could expect that:
- A. Each RN would coordinate care for a group of clients.
- B. One RN would pass meds for all clients on a unit.
- C. Each RN would deliver total care to an assigned group of clients.
- D. One RN, one LPN, and one unlicensed assistive personnel would share responsibility for a group of clients.
Correct Answer: B
Rationale: The correct answer is B because in a functional nursing delivery system, one RN typically administers medications for all clients on a unit. This system allows for efficient distribution of tasks, ensuring that medications are given safely and accurately.
A: Incorrect. Functional nursing does not involve each RN coordinating care for a group of clients.
C: Incorrect. In this system, care tasks are divided among team members, not each RN providing total care to a group of clients.
D: Incorrect. Functional nursing typically does not involve sharing responsibility among different roles like RN, LPN, and unlicensed assistive personnel.
An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?
- A. One or more of the parties may be able to reconcile their values.
- B. The patient’s point of view is recognized as valuable.
- C. The dilemma involves two or more equally unpleasant choices.
- D. The institution is unable to honor the patient’s request.
Correct Answer: C
Rationale: The correct answer is C because when an ethical dilemma involves two or more equally unpleasant choices, it can be challenging for decision-makers to come to a consensus. This is known as a moral dilemma, where there is no clear right or wrong option, making it difficult to reach an agreement. In such cases, individuals may have strong convictions about different courses of action, leading to a deadlock in decision-making.
Incorrect choices:
A: One or more of the parties may be able to reconcile their values - This choice suggests that parties can find common ground by adjusting their values, which is not always possible in complex ethical dilemmas.
B: The patient’s point of view is recognized as valuable - While recognizing the patient's perspective is important, it may not directly address the core reason why an agreement cannot be reached.
D: The institution is unable to honor the patient’s request - This choice focuses on institutional constraints rather than the fundamental nature of ethical dilemmas and decision-making processes.
The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1
diabetes. Which question is most appropriate for the nurse to ask?
- A. "Are you anorexic?"
- B. "Is your urine dark colored?"
- C. "Have you lost weight lately?"
- D. "Do you crave sugary drinks?"
Correct Answer: C
Rationale: The correct answer is C. This question is most appropriate as unintentional weight loss is a common symptom of type 1 diabetes due to the body's inability to properly use glucose for energy. The nurse should ask about weight loss to assess the patient's overall health status.
Explanation:
A: Asking about anorexia assumes a specific eating disorder, which may not be relevant to the patient's symptoms of diabetes.
B: Dark colored urine may indicate dehydration, but it is not specific to type 1 diabetes symptoms.
D: Craving sugary drinks may suggest a preference for sweet beverages but does not directly relate to the onset of type 1 diabetes symptoms.
A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?
- A. Perceived conflict
- B. Disruptive conflict
- C. Competitive conflict
- D. Felt conflict
Correct Answer: B
Rationale: The correct answer is B: Disruptive conflict. This type of conflict occurs when individuals are unwilling to cooperate or communicate effectively, leading to negative consequences. In this scenario, the resident and nurse are engaging in disruptive conflict by refusing to answer calls and retaliating with more calls. This behavior disrupts the communication and collaboration necessary for effective patient care.
A: Perceived conflict is when individuals believe there is a conflict, even if it may not exist. In this case, the conflict is real and not just perceived.
C: Competitive conflict involves individuals trying to outdo each other or win at the expense of the other party. This is not evident in the scenario provided.
D: Felt conflict refers to the emotional response to a conflict situation. While there are emotions involved in the scenario, the main issue is the disruption in communication rather than just feelings.