Which method is most appropriate for managing moral distress in the workplace?
- A. Recognizing that life is unfair and nurses cannot meet every need of every client
- B. Declining to act when clients or visitors make requests that are not justifiable
- C. Developing a new policy that would address the problematic situation
- D. Both A and B
Correct Answer: C
Rationale: The correct answer is C. Developing a new policy is the most appropriate method for managing moral distress in the workplace because it addresses the root cause of the problematic situation. By creating a policy, organizations can provide clear guidelines and procedures to handle ethical dilemmas, thus empowering healthcare professionals to navigate moral challenges effectively.
Choice A is incorrect as it encourages acceptance of unfairness and could lead to moral disengagement. Choice B is also incorrect as declining to act in unjustifiable situations can compromise patient care and violate ethical principles. Choice D is incorrect as it combines two flawed approaches that do not effectively address moral distress. Developing a new policy is the most proactive and systematic approach to managing moral distress in the workplace.
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The discharge planning team is discussing plans for the dismissal of a 16-year-old admitted for complications associated with asthma. The client's mother has not participated in any of the discharge planning processes but has stated that she wants to be involved. Which of the following reasons might prohibit this mother from participating in discharge planning?
- A. The client is an emancipated minor
- B. The mother has to work and is unavailable
- C. The client has a job and a driver's license
- D. The mother does not speak English
Correct Answer: A
Rationale: The correct answer is A: The client is an emancipated minor. Emancipated minors are legally considered adults and have the right to make their own medical decisions without parental involvement. In this case, since the 16-year-old is emancipated, the mother's participation in discharge planning may be prohibited.
Choice B is incorrect because the mother's work schedule does not necessarily prohibit her from participating in discharge planning. Choice C is irrelevant as the client having a job and a driver's license does not impact the mother's ability to participate. Choice D, the mother not speaking English, may present a communication barrier but does not inherently prohibit her from participating.
A client in the emergency room enters the care area to start an IV. He finds a man sitting on the table, hunched over, and attempting to take deep breaths. He states, 'my chest hurts so much!' His wife is sitting on a chair in the corner, crying. Which of the following is the first action of the client?
- A. Bring the IV kit and quickly start an IV
- B. Assess his breathing and provide oxygen, if necessary
- C. Administer medication to control chest pain
- D. Talk with his wife and find out why she is crying
Correct Answer: B
Rationale: The correct answer is B: Assess his breathing and provide oxygen if necessary. This is the first action the client should take because the patient is presenting with chest pain and difficulty breathing, which could indicate a serious medical condition like a heart attack or pulmonary embolism. By assessing the patient's breathing and providing oxygen if needed, the client can help stabilize the patient's condition and ensure proper oxygenation. Starting an IV or administering medication should come after assessing and stabilizing the patient's respiratory status. Talking with the wife, while important for gathering information, is not the priority in this situation.
Upon admission to the stroke care unit of a rehabilitation center, what is the primary action of the nurse?
- A. Collect and organize documents for the client's medical record
- B. Prepare the client's identification bracelet
- C. Identify pertinent health history data and current needs and limitations
- D. Gather the client's valuables and secure them in a locked container
Correct Answer: C
Rationale: The correct answer is C because identifying pertinent health history data and current needs and limitations is crucial in developing an individualized care plan for the stroke patient. This data helps determine the appropriate interventions and therapies needed for the client's recovery. Collecting and organizing documents (choice A) can be important but not the primary action. Preparing an identification bracelet (choice B) and gathering valuables (choice D) are important tasks but not the immediate priority upon admission.
When taking Mr. D's blood pressure, the first sound you hear is at 162, and the second sound you hear is at 86. You should document and report that the blood pressure is _____________.
- A. 86/162
- B. irregular and high
- C. 162/86
- D. normal for people of all ages
Correct Answer: C
Rationale: The correct answer is C: 162/86. The first sound heard corresponds to the systolic pressure (top number) and the second sound heard corresponds to the diastolic pressure (bottom number). Therefore, the blood pressure is documented as systolic/diastolic. In this case, the first sound at 162 indicates the systolic pressure, and the second sound at 86 indicates the diastolic pressure. Alternatives A (86/162) is incorrect as systolic pressure always comes first. B (irregular and high) is incorrect as the blood pressure values are within normal range. Option D (normal for people of all ages) is incorrect because the blood pressure should be documented as per standard practice, regardless of age.
A client is refusing to undergo any more treatments in the hospital and wants to leave against medical advice. When the nurse requests the client to sign an AMA order, the client refuses and leaves. What is the next action of the nurse?
- A. Call security to hold the client until he signs the order
- B. Notify the physician to convince the client to stay
- C. Speak with the client's spouse to persuade him to stay
- D. Allow the client to leave and document the refusal in his chart
Correct Answer: D
Rationale: The correct answer is D: Allow the client to leave and document the refusal in his chart. This is the appropriate action because every individual has the right to refuse medical treatment, even if it is against medical advice. By allowing the client to leave and documenting the refusal in the chart, the nurse respects the client's autonomy and ensures legal and ethical considerations are met. Calling security to hold the client (choice A) would violate the client's rights. Notifying the physician to convince the client (choice B) may not be effective and goes against the client's autonomy. Speaking with the client's spouse (choice C) is irrelevant as the decision lies with the client.
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