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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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A healthcare professional is admitting a client who has rubella. Which of the following types of transmission-based precautions should the nurse initiate?
- A. Airborne
- B. Protective environment
- C. Contact
- D. Droplet
Correct Answer: B
Rationale: The correct answer is B: Protective environment. Rubella is transmitted through droplets and requires the use of protective environment precautions due to its high infectivity. This includes a private room with controlled airflow and specialized ventilation. Airborne precautions (A) are for diseases spread through small particles in the air, like tuberculosis. Contact precautions (C) are for diseases spread by direct or indirect contact with the patient or their environment. Droplet precautions (D) are for diseases transmitted through respiratory droplets, like influenza. In the case of rubella, protective environment precautions are necessary to prevent the spread of the virus to other vulnerable individuals.
A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?
- A. Ask the client to consider a direct donation
- B. Withhold the blood transfusion
- C. Ask the client to consider a direct donation
- D. Request a consultation with the ethics committee
Correct Answer: A
Rationale: The correct answer is A. Asking the client to consider a direct donation respects their religious beliefs while also addressing the partner's concerns. This option promotes patient autonomy and involves the client in decision-making.
B: Withholding the blood transfusion disregards the client's autonomy and may lead to ethical issues.
C: This is a repeated option and does not provide a different course of action.
D: Requesting a consultation with the ethics committee may delay necessary treatment and should be considered only when there is a significant ethical dilemma beyond this situation.
A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?
- A. Blood pressure 144/82 mm Hg
- B. Urine specific gravity 1.03
- C. Neck vein distention
- D. Urine specific gravity 1.01
Correct Answer: A
Rationale: The correct answer is A. The elevated blood pressure of 144/82 mm Hg indicates dehydration due to vomiting and diarrhea, leading to hypovolemia. This is a compensatory mechanism by the body to maintain perfusion. Option B, urine specific gravity of 1.03, indicates concentrated urine and dehydration, but not as specific as elevated blood pressure. Option C, neck vein distention, is more indicative of heart failure or fluid overload rather than dehydration. Option D, urine specific gravity of 1.01, indicates diluted urine and is not consistent with dehydration. Therefore, based on the symptoms and the compensatory mechanism of the body, an elevated blood pressure is the most likely finding in a client with vomiting and diarrhea.
Your nurse manager talks with you once per week to determine how you are adjusting to your role as a new nurse. She asks if you feel that you are able to provide good care to your patients, whether you are becoming familiar with the electronic health record, and whether your preceptor is encouraging your independence. This manager is demonstrating:
- A. An intrusive style.
- B. An effort to understand if you are coping with the demands.
- C. An attempt to intimidate.
- D. An authoritarian style.
Correct Answer: B
Rationale: The correct answer is B because the nurse manager is showing genuine concern for the new nurse's well-being and professional development. By asking about the nurse's ability to provide care, familiarity with the EHR, and support from the preceptor, the manager is seeking to understand and support the nurse's adjustment to the new role. This approach fosters open communication and a supportive environment.
Incorrect Choices:
A: An intrusive style implies invading personal boundaries, which is not evident in the scenario.
C: Intimidation involves creating fear or anxiety, which is not reflected in the manager's behavior.
D: An authoritarian style is characterized by strict control and limited feedback, which contradicts the manager's supportive and open approach.
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