Which of the following is an example of an ethical dilemma in nursing?
- A. Choosing between two equally undesirable alternatives
- B. Reporting a colleague's unethical behavior
- C. Balancing patient confidentiality with the need to disclose information
- D. Deciding whether to comply with a patient's request that conflicts with professional ethics
Correct Answer: D
Rationale: The correct answer is D because it presents a situation where a nurse must navigate conflicting values, such as respecting patient autonomy while upholding professional ethical standards. By complying with the patient's request, the nurse may compromise ethical principles.
A: Choosing between two equally undesirable alternatives is a moral dilemma, not necessarily an ethical dilemma.
B: Reporting a colleague's unethical behavior is an ethical obligation, not a dilemma.
C: Balancing patient confidentiality with the need to disclose information is an ethical consideration, but it does not inherently present a dilemma as it can be managed through established guidelines.
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When a client who is in pain refuses to be repositioned, what should the nurse consider first in making a decision about what to do?
- A. Why a decision is needed.
- B. Who actually gets to make the decision?
- C. What are the alternatives?
- D. When a decision is needed.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Understanding why a decision is needed is crucial in this situation to prioritize the client's well-being.
2. The nurse needs to assess the reasons behind the client's refusal to be repositioned, considering factors such as pain level and potential harm.
3. By determining the underlying cause, the nurse can make an informed decision on the best course of action to address the client's needs promptly.
4. Considering the alternatives (choice C) is important but secondary to understanding the urgency and necessity of the decision (choice A).
5. Who makes the decision (choice B) and when it is needed (choice D) are not as critical as the rationale behind the decision-making process.
Summary:
Choice A is correct because understanding the reason for the decision is essential for prioritizing the client's well-being. Choices B, C, and D are incorrect as they do not directly address the immediate need to assess the situation and make an informed decision based on the client's condition
Which of the following is an example of a sentinel event?
- A. A patient fall with no injury
- B. A medication error that results in no harm
- C. A patient suicide while in a healthcare facility
- D. A near miss incident
Correct Answer: C
Rationale: The correct answer is C because a sentinel event is a serious, unexpected occurrence in a healthcare setting that results in death or serious physical or psychological harm to a patient. A patient suicide while in a healthcare facility meets this criteria. A is incorrect as a fall with no injury is not a sentinel event. B is incorrect as a medication error resulting in no harm is not a sentinel event. D is incorrect as a near miss incident, although serious, does not result in harm to the patient.
When trying to facilitate change in the staff, it is necessary to build trust and recognize the need for change. This type of action is known as which of the following, according to Lewin's Force-Field Model?
- A. Moving the system to a new level
- B. Unfreezing the system
- C. Refreezing the system
- D. Institutionalization
Correct Answer: B
Rationale: The correct answer is B: Unfreezing the system. In Lewin's Force-Field Model, unfreezing refers to the process of preparing individuals and systems for change by breaking down existing mindsets and behaviors. Building trust and recognizing the need for change are essential steps in unfreezing. Moving the system to a new level (A) is not specific to the initial stage of change. Refreezing the system (C) occurs after change has been implemented, not before. Institutionalization (D) involves integrating the change into the organization's culture, which is a later stage in the change process.
What is the primary role of a nurse in a patient-centered medical home (PCMH)?
- A. Coordinate patient care
- B. Administer treatments
- C. Provide health education
- D. Conduct research
Correct Answer: A
Rationale: The primary role of a nurse in a PCMH is to coordinate patient care. This involves ensuring all aspects of a patient's care are well-managed, communicating with various healthcare providers, and advocating for the patient's needs. This role aligns with the core principles of a PCMH, which emphasize comprehensive, coordinated, and patient-centered care. Administering treatments (B) is typically the role of physicians or other healthcare providers. Providing health education (C) is important but not the primary role of a nurse in a PCMH. Conducting research (D) is not a direct responsibility of nurses in a clinical setting like a PCMH.
The staff nurse delegates AM care for two patients to the UAP (Unlicensed Assistive Person). What principle of delegation is the nurse following?
- A. Delegation requires a situation with clearly defined superiors.
- B. Delegation can only exist with a subordinate.
- C. Delegation is a tool used by various healthcare professionals.
- D. You can delegate only those tasks.
Correct Answer: D
Rationale: The correct answer is D because delegation involves transferring responsibility for a task while retaining accountability for the outcome. The nurse has delegated specific tasks (AM care) to the UAP, which aligns with the principle that only certain tasks can be delegated. Choice A is incorrect because delegation does not require clearly defined superiors, but rather defined tasks. Choice B is incorrect as delegation can also occur between peers or team members. Choice C is incorrect as delegation is not exclusive to healthcare professionals but is a common practice in various industries.