Nokea
Which element is not necessary to prove nursing malpractice?
- A. Breach of duty.
- B. Identify the ethical issues.
- C. Injury to the client.
- D. Proximate cause.
Correct Answer: B
Rationale: Malpractice requires duty, breach, injury, and causation. Identifying ethical issues is not a legal element, though relevant to ethics.
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The 78-year-old Catholic client is in end-stage congestive heart failure and has a DNR order. The client has AP 50, RR 10, and BP 80/50, and Cheyne-Stokes respirations. Which action should the nurse implement?
- A. Bring the crash cart to the bedside.
- B. Apply oxygen via nasal cannula.
- C. Notify a priest for last rites.
- D. Turn the bed to face the sunset.
Correct Answer: C
Rationale: Notifying a priest for last rites respects Catholic end-of-life practices, a priority with imminent death. Crash cart violates DNR, oxygen is less critical, and bed orientation is irrelevant.
The nurse must be knowledgeable of ethical principles. Which is an example of the ethical principle of justice?
- A. The nurse administers a placebo, and the client asks if it will help the pain.
- B. The nurse accepts a work assignment in an area in which he or she is not experienced.
- C. The nurse refuses to tell a family member the client has a positive HIV test.
- D. The nurse provides an indigent client with safe and appropriate nursing care.
Correct Answer: D
Rationale: Justice ensures equitable care, like providing safe care to an indigent client. Placebos (deception), incompetence, or confidentiality are unrelated to justice.
The charge nurse is making assignments on an oncology floor. Which client should be assigned to the most experienced nurse?
- A. The client diagnosed with leukemia who has a hemoglobin of 6 g/dL.
- B. The client diagnosed with lung cancer with a pulse oximeter reading of 89%.
- C. The client diagnosed with colon cancer who needs the colostomy irrigated.
- D. The client diagnosed with Kaposi's sarcoma who is yelling at the staff.
Correct Answer: A
Rationale: Hemoglobin of 6 g/dL indicates severe anemia, requiring complex monitoring and transfusion, best handled by an experienced nurse. Hypoxia, colostomy care, or behavior are less acute.
The client diagnosed with diabetes mellitus type 2 wants to be an organ donor and asks the nurse, 'Which organs can I donate?' Which statement is the nurse's best response?
- A. It is wonderful you want to be an organ donor. Let's discuss this.
- B. You can donate any organ in your body, except the pancreas.
- C. You have to donate your body to science to be an organ donor.
- D. You cannot donate any organs, but you can donate some tissues.
Correct Answer: D
Rationale: Type 2 diabetes may contraindicate organ donation (e.g., kidneys, pancreas) due to vascular damage, but tissues (e.g., corneas) are often viable. Other responses are inaccurate.
The client is three (3) hours post-heart transplantation. Which data would support a complication of this procedure?
- A. The client has nausea after taking the oral antirejection medication.
- B. The client has difficulty coming off the heart-lung bypass machine.
- C. The client has saturated three (3) ABD dressing pads in one (1) hour.
- D. The client complains of pain at a '6' on a 1-to-10 scale.
Correct Answer: C
Rationale: Excessive bleeding (saturated dressings) indicates a surgical complication, requiring urgent intervention. Nausea, bypass difficulty, or moderate pain are less immediate.