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When first diagnosed with Parkinson disease, how can the patient and family best avoid future ethical dilemmas concerning the patient's care?
- A. Work with the patient and family to create an advanced plan of care.
- B. Explain to the family that the patient's cognitive function will deteriorate as time passes.
- C. Discuss the patient's religious and spiritual concerns to identify potential problems.
- D. Identify which family members will be in control of decision making for the patient.
Correct Answer: A
Rationale: The correct answer is A: Work with the patient and family to create an advanced plan of care. This is the best way to avoid ethical dilemmas because it involves proactive decision-making and communication among all parties involved. By creating an advanced plan of care, the patient and family can outline the patient's preferences, values, and goals for future care, ensuring that decisions align with the patient's wishes. This helps prevent potential conflicts and ensures that everyone is on the same page regarding the patient's care.
Choices B, C, and D are incorrect:
B: Explaining cognitive decline does not directly address how to avoid ethical dilemmas and may cause unnecessary distress.
C: Discussing religious and spiritual concerns is important but may not specifically address future ethical dilemmas related to care decisions.
D: Identifying family members in control of decision-making does not necessarily prevent ethical dilemmas and may overlook the patient's autonomy and preferences.
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A Hispanic patient is visited by several family members and the nurse witnessed one visitor who pinches a piece of skin at the waist. The nurse asks the purpose and learns the "provider" is listening for a snap from the abdominal region, which is then repeated several times. The patient most likely suffers from:
- A. mal ojo.
- B. susto.
- C. bilis.
- D. empacho.
Correct Answer: D
Rationale: The correct answer is D: empacho. Empacho is a traditional Hispanic folk illness characterized by a blockage in the digestive system. In this scenario, the behavior of pinching the skin and listening for a snap in the abdominal region aligns with the common practice associated with empacho diagnosis. The family member is likely trying to detect an abnormal sound, indicating a blockage in the intestines. The other choices (A: mal ojo, B: susto, C: bilis) do not fit the description of the observed behavior and symptoms. Mal ojo refers to the evil eye, susto is a fright-related illness, and bilis pertains to an imbalance of bodily fluids, none of which involve the specific diagnostic behavior described in the scenario.
A patient is admitted for a hip replacement complicated by uncontrolled diabetes and early dementiThe nurse coordinates referrals to an endocrinologist to establish an insulin protocol and organizes out-patient physical therapy in an Alzheimer's assisted living facility upon discharge. The role of this nurse is the:
- A. informatics specialist.
- B. educator.
- C. case manager.
- D. quality manager.
Correct Answer: C
Rationale: Step-by-step rationale for why choice C (case manager) is correct:
1. A case manager coordinates referrals and services for patients with complex needs, such as this patient with diabetes and dementia.
2. In this scenario, the nurse is coordinating referrals to an endocrinologist and organizing physical therapy, which aligns with the role of a case manager.
3. Case managers ensure continuity of care and facilitate communication between different healthcare providers.
4. The nurse's role in organizing follow-up care and services for the patient falls under the responsibilities of a case manager.
Summary of why other choices are incorrect:
A: Informatics specialist - This role focuses on managing health information systems, not coordinating referrals and services for patients.
B: Educator - While education may be a component of the nurse's role, the primary focus in this scenario is on coordinating referrals and services, which is more in line with a case manager's responsibilities.
D: Quality manager - Quality managers focus on ensuring healthcare services meet quality standards
A novice nurse is placed in charge just after orientation ends. Which statement by the novice nurse would ensure a smooth delegation experience when delegating to an experienced staff member?
- A. "You have the patients in rooms 1 to
- B. "I need your help; let me know your suggestions."
- C. "You’re experienced, so take over and decide."
- D. "I’m in charge, so do as I say."
Correct Answer: B
Rationale: The correct answer is B because it demonstrates respect for the experienced staff member's expertise by asking for their input and suggestions. This approach fosters open communication, encourages collaboration, and shows a willingness to learn from others. Choice A lacks clarity and assumes the staff member knows the patients in question. Choice C is presumptuous and dismissive of the staff member's autonomy. Choice D is authoritarian and does not promote a positive working relationship. Ultimately, choice B promotes teamwork and mutual respect, leading to a smoother delegation process.
A nurse is responsible for determining the incidence rates of hospital-acquired diarrhea on a pediatric ward after receiving reports that five children admitted with uncontrolled asthma had developed diarrhea while hospitalized. The nurse is working in the role of:
- A. quality management.
- B. infection control.
- C. occupational health.
- D. forensics.
Correct Answer: B
Rationale: The correct answer is B: infection control. In this scenario, the nurse is focusing on preventing and controlling the spread of hospital-acquired diarrhea among pediatric patients. By investigating the incidence rates and implementing measures to reduce the risk of infection transmission, the nurse is fulfilling the role of infection control. Quality management (A) focuses on improving processes and outcomes, not specifically on infection prevention. Occupational health (C) involves ensuring workplace safety for employees, not patient infection control. Forensics (D) involves investigating and analyzing evidence related to crimes or legal matters, not infection control in a healthcare setting.
A community health nurse has been visiting a postpartum client who suffered domestic violence throughout the pregnancy, and now the infant may be at risk. The nurse assisted the client in finding shelter and legal protection. The nurse's role and the conceptual framework involved are:
- A. change agent, according to Roy's adaptation model.
- B. translator, according to Leininger's theory of cultural care diversity and universality.
- C. case manager, according to Peplau's interpersonal relations model.
- D. caregiver, according to Rogers' science of unitary human beings.
Correct Answer: C
Rationale: The correct answer is C: case manager, according to Peplau's interpersonal relations model. In this scenario, the nurse is coordinating resources and services for the client, which aligns with the role of a case manager. Peplau's model emphasizes the therapeutic relationship between the nurse and client, focusing on understanding the client's needs and providing support. The nurse in this situation is not just providing direct care (caregiver), advocating for change (change agent), or focusing solely on cultural aspects (translator). The nurse's role as a case manager involves addressing the client's complex needs, coordinating care, and advocating for the client's well-being, making it the most appropriate choice in this context.