Nokea
Which of the following family interactions would the nurse most likely interpret as being atypical?
- A. Mr. R states that he and his brother always had a cordial, though somewhat distant, relationship but that they are now quite close.
- B. Mrs. D describes being a grandparent as 'having all the benefits of having children without the headaches and responsibilities.'
- C. Mr. and Mrs. N had a tumultuous relationship for decades but now appear more at ease with one another.
- D. Mr. A states that his ideal living situation would be himself and his adult son and daughter all under the same roof.
Correct Answer: D
Rationale: The correct answer is D. While marital reconciliation, rekindled relationships with siblings, and satisfaction in the role of grandparent are common phenomena among older adults, it is less common for parents and children to see cohabitation as an ideal situation or first preference. Choices A, B, and C reflect common positive family dynamics experienced by older adults, such as improved relationships with siblings, contentment in the grandparent role, and easing of marital tensions over time. On the other hand, choice D stands out as atypical as it suggests an unconventional living arrangement where adult children live with their parent, which is less commonly preferred by older adults.
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A gerontological nurse is providing care at a local community health center that serves large black American and white American older adult populations. The nurse is working to develop culturally appropriate programs to meet each group's health needs and notes differences in health status between the groups. Which reason would the nurse most likely identify as accounting for the differences between the populations?
- A. High incidence of violent crime and sexually transmitted diseases in the black population
- B. Reliance on family for health care advice and rejection of formal service agencies in the white population
- C. Cultural preference for unconventional medical treatments like herbal remedies in the white population
- D. Lower standard of living and less access to health care services in the black population
Correct Answer: D
Rationale: The correct answer is D. Black older adults historically possess many health problems that have accumulated over a lifetime due to a poor standard of living and limited access to health care services. Option A is incorrect because it presents stereotypes about the black population that are not supported by evidence. Option B is incorrect because it generalizes the behavior of the white population without a strong basis. Option C is incorrect as it also generalizes the white population and does not address the disparities in health status between the two groups.
Nurse R works on the geriatric medicine unit of the university hospital and provides care for numerous older adult clients nearing the end of life, many of whom have no-code orders. Which of the following situations is incompatible with the legal requirements for a no-code order?
- A. A client who is mentally competent has declared his wish to have a no-code order despite the availability of treatment options for his condition.
- B. A client has expressed her desire to have a no-code order but her daughter is adamantly opposed to it.
- C. A client clearly tells the nurse her desire to have a no-code order, which the nurse documents at the bedside.
- D. A client has been in a coma and the family has decided to put in place a no-code order.
Correct Answer: C
Rationale: The correct answer is C. No-code orders require a written and signed order by a physician. Therefore, a client expressing the desire for a no-code order to a nurse, without a documented physician's order, is incompatible with legal requirements. Choices A and B are not incompatible as competent clients can make their own decisions, regardless of treatment options or family opposition. Choice D is also not incompatible as family decisions can be made on behalf of incompetent clients.
Which of the following actions can a nurse safely take without risk of liability?
- A. Questioning a doctor's written orders for medication
- B. Permitting a volunteer to move a patient
- C. Using a blood pressure cuff that is sometimes sticking
- D. Asking a family member to deliver routine medication to a patient's room
Correct Answer: A
Rationale: The correct answer is A: Questioning a doctor's written orders for medication. Under the doctrine of respondent superior, nurses can face liability risks for various actions. Permitting volunteers to move patients, using malfunctioning equipment, or tasking unqualified staff can pose liability risks. Questioning medication orders is a responsibility to ensure patient safety. It is crucial for nurses to clarify any doubts or raise concerns about medication orders to prevent potential harm to patients.
Nurse M obtains a signature on an informed consent form from Mr. Y, who is later shown to have a fluctuating level of mental competency. In this case, what is Nurse M's most likely legal position?
- A. Freedom from liability because Mr. Y signed the form
- B. Possibly liable for a violation of Mr. Y's rights
- C. Liable unless a malpractice insurance policy is in effect
- D. Not liable because no family member had a durable power of attorney
Correct Answer: B
Rationale: An informed consent may be considered invalid if the patient does not fully understand what he or she is signing. Patients with a fluctuating level of mental function are incapable of granting legally sound consent. Nurse M could be held liable for a violation of Mr. Y's rights as he did not have the capacity to provide informed consent. The presence of an insurance policy and the legal status of family members are irrelevant in this context and do not absolve Nurse M of potential liability.
A 52-year-old woman is preparing to have her father move into her home after his discharge from the hospital. Which of the following subjects should the discharge planning nurse prioritize when preparing the woman for her new caregiving role?
- A. The availability and scope of community resources
- B. The importance of her own self-care and techniques for maximizing it
- C. Assertiveness training to ensure she can set limits
- D. Management of finances
Correct Answer: B
Rationale: The correct answer is B. It is crucial for the discharge planning nurse to prioritize the importance of the woman's self-care and provide techniques for maximizing it. When taking on a caregiving role, the caregiver's well-being is essential to ensure effective care for the patient. While community resources (choice A) are important, the immediate focus should be on self-care. Assertiveness training (choice C) and financial management (choice D) are also significant but not as critical as self-care for the caregiver in this scenario.