Nokea
Which nursing intervention is an independent function of the professional nurse?
- A. Administering oral analgesics
- B. Requesting diagnostic studies
- C. Teaching the patient perineal care
- D. Providing wound care to a surgical incision
Correct Answer: A
Rationale: Administering oral analgesics is an independent function of the professional nurse. Independent nursing interventions are those that a nurse is licensed to initiate based on their knowledge and skills without needing an order from a healthcare provider. Nurses are educated and trained in medication administration, including oral analgesics, and can independently assess the need for and safely administer them within their scope of practice. While requesting diagnostic studies, teaching perineal care, and providing wound care are essential nursing interventions, they typically require some form of healthcare provider's order or supervision, making them more interdependent activities.
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A 55-year-old postmenopausal female patient presents to the family practice clinic for her annual examination. The nurse notes that the patient has lost inch in height. Upon further investigation, the nurse discovers that the patient has a slow-healing fracture of the left radius. What screening will most likely be initiated at this time for the patient?
- A. Assessment for domestic violence
- B. Dual-energy x-ray absorptiometry scan
- C. Follicle-stimulating hormone
- D. Serum levels of calcium and vitamin D
Correct Answer: B
Rationale: In this scenario, the postmenopausal female patient who has lost height and has a slow-healing fracture of the left radius presents with concerning factors for osteoporosis. The most appropriate screening to initiate in this case would be a dual-energy x-ray absorptiometry (DEXA) scan. DEXA scan is the gold standard for diagnosing osteoporosis by measuring bone mineral density. Given the patient's age, postmenopausal status, height loss, and fracture history, assessing bone health through a DEXA scan is crucial to determine the presence of osteoporosis and guide appropriate management and treatment strategies.
A Vietnamese patient who speaks little English is admitted to the labor and birth unit in early labor. The nurse plans to use an interpreter during an initial assessment. Which should the nurse plan to implement with regard to using an interpreter? (Select all that apply.)
- A. Face the interpreter when speaking.
- B. Listen carefully to what the patient says.
- C. Speak slowly and smile when appropriate.
- D. Plan to use a male interpreter, even if a female interpreter is available.
Correct Answer: A
Rationale: A. Face the interpreter when speaking: By facing the interpreter when speaking, the nurse ensures clear communication and demonstrates respect for the interpreter's role in facilitating understanding between the patient and healthcare provider.
A nurse working in a labor and birth unit is asked to take care of two high-risk patients in the labor and birth suite: a 34 weeks’ gestation 28-year-old gravida 3, para 2 in preterm labor and a 40-year-old gravida 1, para 0 who is severely preeclamptic. The nurse refuses this assignment telling the charge nurse that based on individual patient acuity, each patient should have one-on-one care. Which ethical principle is the nurse advocating?
- A. Accountability
- B. Beneficence
- C. Justice
- D. Fidelity
Correct Answer: C
Rationale: Justice is the ethical principle that involves fair and equal distribution of resources and care. In this scenario, the nurse is advocating for justice by asserting that each high-risk patient should receive one-on-one care based on their individual acuity levels. By refusing to take on both patients simultaneously, the nurse is advocating for fairness and equal opportunity for proper care and attention for each patient. This is in line with the principle of justice, which emphasizes the importance of treating all individuals fairly and providing them with the appropriate level of care they need.
A nurse is caring for a patient with increased urination and pain with urination. What finding would the nurse expect if the patient has a UTI?
- A. white blood cells in urine
- B. ketones in urine
- C. blood in urine
- D. protein in urine
Correct Answer: A
Rationale: When a patient has a urinary tract infection (UTI) they may have increased white blood cells (leukocytes) in their urine. White blood cells are a sign of inflammation and infection in the urinary tract. It is a common finding in patients with UTIs. Symptoms such as increased urination and pain with urination are classic signs of a UTI. Therefore, the nurse would expect to see white blood cells in the urine of a patient with a UTI.
A nurse who works in the emergency department (ED) is assigned to a patient who is experiencing heavy vaginal bleeding at 12 weeks’ gestation. An ultrasound has confirmed the absence of a fetal heart rate, and the patient is scheduled for a dilation and evacuation of the pregnancy. The nurse refuses to provide any further care for this patient based on moral principles. What is the nurse manager’s initial response to the nurse?
- A. “I recall you sharing that information in your interview. I will arrange for another nurse to take report on this patient.”
- B. “Because we are shorthanded today, you have to continue to provide care. There is no one else available to provide care for this patient.”
- C. “I understand your point of view. You were hired to work here in the ED so you had to know this situation was possible.”
- D. “Abandonment is a serious issue. I have to advise you to continue to provide care for this patient.”
Correct Answer: D
Rationale: The nurse manager's initial response should prioritize patient care and safety. In this situation, the patient requires urgent medical attention due to heavy vaginal bleeding and the need for a dilation and evacuation procedure. The nurse's refusal to provide care based on personal moral principles can be considered as patient abandonment, which is a serious ethical and legal issue in healthcare. The nurse manager must advise the nurse to continue providing care for the patient to ensure that the patient's needs are met and to prevent harm resulting from abandonment. The nurse manager should also address the nurse's concerns separately through appropriate channels, such as discussing ethical considerations, providing support, and exploring options for accommodation or transfer if necessary.