Nokea
Which functions can be delegated only to another RN with appropriate experience and training? (select all that apply)
- A. Assessment of skin integrity on third day of hospitalization
- B. Evaluation of patient teaching related to turn, cough, and deep breathing exercises
- C. Nursing judgment related to withholding medication based on vital signs
- D. RNs do not delegate to other RNs, they delegate only to licensed practical nurses or unlicensed assistive personnel
Correct Answer: C
Rationale: The correct answer is C because nursing judgment related to withholding medication based on vital signs requires critical thinking, clinical knowledge, and experience. This decision-making process involves assessing the patient's condition, interpreting vital signs, and determining if medication should be given or withheld to ensure patient safety. This function cannot be delegated to someone without the appropriate training and expertise.
A: Assessment of skin integrity on the third day of hospitalization can be delegated to other healthcare team members such as LPNs or nursing assistants, as long as they have been trained and deemed competent.
B: Evaluation of patient teaching related to turn, cough, and deep breathing exercises can be delegated to other healthcare team members, as long as they have the appropriate training and supervision.
D: The statement that RNs do not delegate to other RNs is incorrect. RNs can delegate certain tasks to other RNs based on their scope of practice and level of experience. It is not limited to LPNs or unlicensed assistive personnel.
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A nurse practicing on a unit where domestic violence is common wants to learn how to apply nursing theory to practice on this unit. She considers the interrelatedness of the constructs of Watson's Theory of Caring and designs:
- A. conceptual model of caring.
- B. hypothesis of the impact of caring on domestic violence.
- C. proposition of how caring is conceptualized.
- D. theory of scientific inquiry.
Correct Answer: A
Rationale: The correct answer is A: conceptual model of caring. In this scenario, the nurse wants to apply nursing theory to practice in a unit dealing with domestic violence. Watson's Theory of Caring emphasizes the importance of the nurse-patient relationship, which is central when addressing sensitive issues like domestic violence. By considering the interrelatedness of the constructs of this theory, the nurse can develop a conceptual model that guides her practice in providing caring and compassionate care to domestic violence survivors. This model will help her incorporate key elements of caring, such as empathy and respect, into her nursing interventions.
Summary:
B: Hypothesis of the impact of caring on domestic violence - This choice is incorrect as it focuses on the impact of caring on domestic violence, rather than the application of a nursing theory to practice.
C: Proposition of how caring is conceptualized - This choice is incorrect as it only addresses the conceptualization of caring, not the practical application of a nursing theory to practice.
D: Theory of scientific
Nurses caring for the victims of a mass casualty incident:
- A. determine the common terminology to be used by hospitals and participating agencies.
- B. take charge of communicating with the news media.
- C. determine whether there is a credible threat of a terrorist attack.
- D. give priority for care to those with the greatest chance of survival rather than those most critically ill.
Correct Answer: D
Rationale: The correct answer is D because prioritizing care based on the greatest chance of survival maximizes the number of lives saved in a mass casualty incident. This approach follows the principle of triage, which aims to allocate resources efficiently. Choice A is incorrect as it pertains to coordination rather than immediate patient care. Choice B is incorrect as it is not the primary role of nurses during a mass casualty incident. Choice C is incorrect as determining a credible threat is the responsibility of security and law enforcement, not nurses.
The nurse caring for a patient states, "Your blood pressure is dangerously high. Are you taking antihypertensive medicine?" The patient states, "I can't afford my medicine. I have no insurance." The nurse states "I feel really sorry for that patient. I wish it wasn't against policy to give her money." The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that "She was so sick last evening when she came to the ED. I can't believe they don't provide insurance. I can't give her money but you all can help." This nurse:
- A. is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines.
- B. is at risk for HIPAA violations.
- C. has properly followed policy and protected the patient by not using her name.
- D. is demonstrating the logical fallacy of slippery slope.
Correct Answer: B
Rationale: The correct answer is B because the nurse is at risk for HIPAA violations by sharing patient information on social media. The Health Insurance Portability and Accountability Act (HIPAA) protects patients' privacy and prohibits healthcare providers from disclosing their health information without consent. In this scenario, the nurse shared specific details about the patient's health condition, visit to the ED, and financial situation, which could easily identify the patient. This violates the patient's right to privacy and confidentiality. Choices A, C, and D are incorrect because the focus should be on the HIPAA violation rather than empathy, policy following, or logical fallacies. The nurse should have found alternative ways to help the patient without compromising their privacy.
An elderly person, age 80, is finding it difficult to live alone and the family is considering long-term care. The elderly person is reasonably healthy, with only normal aging declines, and maintains a healthy appetite. All medications are administered orally and require only minimal assistance. She is financially secure with an income based on retirement from both the military and factory from her deceased husband and herself. The family contacts long- term care and is told that, based on this patient's information:
- A. Medicare will cover the cost of stay since skilled services are required.
- B. Medicaid is only for families with dependent children.
- C. Medicare will pay for home health services should these additional services meet the needs of the individual.
- D. Medicare will pay regardless of household income or financial status for nursing home care.
Correct Answer: C
Rationale: Rationale for Correct Answer (C): Medicare will pay for home health services should these additional services meet the needs of the individual.
1. Medicare covers home health services for individuals who meet specific criteria, which may include being homebound, needing skilled nursing care, and having a care plan established by a healthcare provider.
2. In this scenario, the elderly person is reasonably healthy and only requires minimal assistance with oral medications, indicating that she may benefit from home health services rather than long-term care.
3. Since the elderly person is financially secure, it is likely that she does not meet the eligibility criteria for Medicaid, which is a need-based program for individuals with limited income and resources.
4. Medicare does not cover long-term care in a nursing home unless specific criteria are met, such as requiring skilled services on a short-term basis. In this case, the elderly person's need for assistance with oral medications does not necessarily qualify as a skilled service for nursing home care.
Summary of Incorrect Choices:
A
Although the media portrayed nursing in a negative light in M*A*S*H through the character of a promiscuous, uncaring nurse, it also provided Americans with a promising glimpse of:
- A. nurses who can be promiscuous and still help doctors.
- B. the fact that caring is not as important as the desire to serve one's country.
- C. the ability of nurses to cope with the dreadfulness of war by using humor.
- D. the contributions of male military nurses.
Correct Answer: C
Rationale: The correct answer is C because the media in M*A*S*H showed how nurses coped with the horrors of war through humor, highlighting their resilience and adaptability. This is a positive portrayal of nurses as capable and strong individuals. Choices A and B are incorrect as they misrepresent the values and professionalism of nurses. Choice A promotes negative stereotypes, while choice B undermines the importance of compassion in nursing. Choice D is incorrect as the show primarily focused on female nurses, not male nurses.