Nokea
Which action by the nurse working with a client best demonstrates respect for autonomy?
- A. Asks if the client has questions before signing a consent
- B. Gives the client accurate information when questioned
- C. Treats the client fairly compared to other clients
- D. Keeps promises made to the client
Correct Answer: A
Rationale: Autonomy is self-determination. The client should make decisions regarding care. When the nurse obtains a signature on the consent form, assessing if the client still has questions is vital, because without full information the client cannot practice autonomy. Giving accurate information is practicing veracity. Keeping promises is upholding fidelity. Treating the client fairly is providing social justice.
You may also like to solve these questions
A nurse manager wants to improve hand-off communication among the staff. What actions by the manager would best achieve this goal? (Select all that apply.)
- A. Attend hand-off rounds to coach and mentor
- B. Conduct audits of staff using a new template
- C. Hand-off rounds to coach and mentor
- D. Encourage staff to ask questions during hand-off
- E. Give raises based on compliance with reporting
Correct Answer: A,B,C,D
Rationale: A protocol for standardizing hand-off reports and other critical communication is the SHARE model. Attending hand-off rounds gives the manager opportunities to educate and coach. Conducting audits is part of reinforcing quality. Creating a template is standardizing within the system. Encouraging staff to ask questions and think critically about the information is allowing opportunities to ask questions. Giving raises based on compliance is not part of the SHARE model.
A newly graduated nurse at the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best?
- A. All staff nurses are required to participate in quality improvement here
- B. Even being new, you can implement activities designed to improve care
- C. You are to identify what indicators should be used to measure quality
- D. You should ask to be assigned to the research and quality committee
Correct Answer: B
Rationale: The preceptor should reassure the nurse that implementing QI measures is not out of line for a newly graduated nurse. Even new nurses can contribute to quality improvement by implementing activities designed to enhance care, such as following evidence-based protocols or suggesting small process improvements. Requiring participation, assigning specific tasks like identifying indicators, or suggesting committee assignment may not address the nurse's concern about their capability as a new graduate.
The nurse is reviewing the core competencies for health care providers outlined by the Institute of Medicine (IOM). Which of the following are included? (Select all that apply.)
- A. Collaborating with an interdisciplinary team
- B. Implementing evidence-based care
- C. Providing family-focused care
- D. Routinely using informatics in practice
- E. Using quality improvement in client care
Correct Answer: A,B,D,E
Rationale: The IOM report lists five broad core competencies that all health care providers should practice. These include collaborating with the interdisciplinary team, implementing evidence-based practice, providing client-focused care, using informatics in client care, and using quality improvement in client care. Providing family-focused care is not explicitly listed as a core competency.
A nurse is caring for a postoperative client on the surgical unit. The client's blood pressure was 142/76 mm Hg 30 minutes ago, and now is 89/50 mm Hg. What action by the nurse is best?
- A. Call the Rapid Response Team
- B. Document and continue to monitor
- C. Notify the primary care provider
- D. Repeat blood pressure measurement in 15 minutes
Correct Answer: A
Rationale: The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating before they suffer respiratory or cardiac arrest. Since the client has experienced a significant change in blood pressure, the nurse should call the RRT. Changes in blood pressure, mental status, heart rate, and pain are particularly significant. Documentation is vital, but the nurse must do more than document. Notifying the primary care provider is important but does not address the immediate need for intervention. Repeating the blood pressure measurement delays necessary action.
A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best demonstrates this concept?
- A. Assesses for cultural influences affecting health care
- B. Ensures that all the clients basic needs are met
- C. Tells the client and family about all upcoming tests
- D. Thoroughly orients the client and family to the room
Correct Answer: A
Rationale: Competency in client-focused care is demonstrated when the nurse focuses on communication, culture, respect, compassion, client education, and empowerment. By assessing the effect of the client's culture on health care, the nurse best demonstrates this concept. Simply telling the client about all upcoming tests is not providing empowering education. Orienting the client and family to the room is an important safety measure, but not directly related to demonstrating client-centered care.