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When an RN is asked to accept an assignment that he or she may not be qualified to perform, the nurse should:
- A. accept the assignment as appropriate if assigned by a legitimate power.
- B. be primarily concerned with the number of patients being assigned.
- C. ask how other nurses have handled the assignment in the past.
- D. determine whether he or she is familiar with the types of patients being assigned.
Correct Answer: D
Rationale: Step-by-step rationale for why Answer D is correct:
1. Ensures patient safety: RN should only accept assignments they are qualified for to provide safe care.
2. Upholds professional standards: Accepting only familiar assignments aligns with nursing scope of practice.
3. Legal and ethical responsibility: RN must prioritize patient well-being over external pressures.
4. Promotes personal growth: RN can seek additional training for unfamiliar assignments.
Summary:
- A: Incorrect. Accepting based on power dynamics disregards patient safety and professional ethics.
- B: Incorrect. Patient safety should be the primary concern over workload.
- C: Incorrect. Past handling may not guarantee appropriateness. Focus should be on personal qualification.
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Which of the following situations would be appropriate for the supervisory level of initial direction and/or periodic inspection?
- A. Experienced RNs work together to provide care for a group of patients newly diagnosed with meningitis.
- B. The RN assigns the LPN tasks within her scope of practice and checks back during the shift to ensure the tasks are completed correctly.
- C. A new graduate nurse is assigned care to a male patient with a hematocrit of 11.0 g of hemoglobin per deciliter and is receiving a blood transfusion. The charge nurse checks on the patient status every 15 to 30 minutes and asks the graduate to explain "next steps."
- D. No supervision is necessary since both are registered nurses.
Correct Answer: B
Rationale: The correct answer is B because the scenario describes a situation appropriate for the supervisory level of initial direction and periodic inspection. The RN assigning tasks to the LPN within her scope of practice and checking back ensures tasks are completed correctly, aligning with the supervisory role. This level of oversight is necessary for safe and effective patient care.
Choice A is incorrect as experienced RNs working together do not require supervisory direction for caring for patients. Choice C involves the charge nurse providing frequent oversight to a new graduate nurse, which is more than just periodic inspection. Choice D is incorrect because regardless of both being registered nurses, supervision may still be necessary, especially when assigning tasks to a different level of healthcare provider like an LPN.
A nurse is preparing to teach a class related to risk factors for cancer to a diverse ethnic group attending a health fair. The nurse should be aware:
- A. that Hispanic women overestimate the prevalence of cancer and strictly following breast self-examination guidelines.
- B. of the importance of risk factors such as smoking and alcohol consumption that increase esophageal cancer when speaking with black.
- C. that American-Indian women have a higher rate of ovarian cancer than the general population.
- D. that cancer as well as heart disease and stroke are lower in ethnic groups.
Correct Answer: C
Rationale: The correct answer is C because it provides accurate information about a specific risk factor related to a particular ethnic group. American-Indian women do have a higher rate of ovarian cancer than the general population, making it crucial for the nurse to be aware of this when teaching about cancer risk factors.
A is incorrect as it discusses breast cancer and not ovarian cancer. B is incorrect as it mentions esophageal cancer, which is not the specific focus of the question. D is also incorrect as it makes a general statement about cancer, heart disease, and stroke in ethnic groups without providing specific information about ovarian cancer in American-Indian women.
During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy?
- A. An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway.
- B. A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power.
- C. A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call.
- D. A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.
Correct Answer: A
Rationale: The correct answer is A because denying the older person with Alzheimer's disease the right to ambulate violates their autonomy by restricting their freedom to make choices about their own body and movement. Autonomy is the ethical principle that respects an individual's right to make decisions about their own health and well-being. In this situation, the person should have the autonomy to decide whether or not they want to ambulate, even if they have advanced Alzheimer's disease.
Choice B is incorrect because the mentally competent adult has the right to refuse medical treatment based on their beliefs, which is an expression of autonomy.
Choice C is incorrect because the mentally competent visitor has the right to refuse examination, which is also an expression of autonomy.
Choice D is incorrect because the mentally competent adult has the right to refuse a local anesthetic, which is also an expression of autonomy.
A nurse entering the job market wants to be certain that the first position is rewarding and allows for growth as a registered nurse. According to the Hallmarks of the Professional Nursing Environment, the nurse should ask:
- A. about the philosophy related to clinical care to determine the role of RNs in deciding outcomes related quality outcomes.
- B. if professional development opportunities are supported through paid leave and tuition reimbursement.
- C. how compensation packages compare to others in the same area and nationally.
- D. what the projected need for RNs is in the next 5 years and current turnover rate.
Correct Answer: B
Rationale: The correct answer is B because professional development opportunities supported through paid leave and tuition reimbursement are crucial for a nurse's growth. This allows for continuous learning, skill enhancement, and career advancement. It indicates that the organization values its nurses and invests in their development. The other choices, A, C, and D, while important in their own right, do not directly address the nurse's growth and professional development. Choice A focuses on the philosophy of care, not personal growth. Choice C is mainly about compensation, not professional development. Choice D pertains to workforce planning, not individual career advancement.
Florence Nightingale is attributed with being intelligent (she developed statistical methods to evaluate health care), dependable (she often worked long hours to care for the injured), and ambitious (she fought against society's perception of nursing). Those who depict her as a leader on the basis of these qualities are practicing which leadership theory?
- A. Trait
- B. Chaos
- C. Bureaucracy
- D. Organizational
Correct Answer: A
Rationale: Step 1: Identify the qualities attributed to Florence Nightingale: intelligent, dependable, ambitious.
Step 2: Recognize these qualities as traits.
Step 3: Trait theory states that effective leaders possess certain traits.
Step 4: Florence Nightingale's leadership qualities align with trait theory.
Step 5: Therefore, depicting her as a leader based on her traits falls under trait theory.
Summary:
A: Trait theory focuses on inherent qualities of leaders, which align with Florence Nightingale's qualities.
B: Chaos theory emphasizes unpredictability and complexity, not relevant here.
C: Bureaucracy theory centers on structured organizations, not applicable to Nightingale's personal traits.
D: Organizational theory addresses structure and management within organizations, not related to individual leadership attributes like traits.