Nokea
Which of the following is required in order for a healthcare provider to be legally justified in not attempting to save a client's life?
- A. A 'Do Not Resuscitate' (DNR) statement on the patient's care plan
- B. A 'No-Code' sign or symbol placed at the patient's bedside
- C. A 'No-Code' order written and signed on the physician's order sheet
- D. The next of kin's request for 'Do Not Resuscitate' orally or in writing
Correct Answer: C
Rationale: To legally justify not attempting to save a client's life, a healthcare provider must have a 'No-Code' order written and signed on the physician's order sheet. Unless there is a specific order stating that resuscitation should not be performed, failure to do so can be considered negligence. A 'Do Not Resuscitate' statement on the care plan or a symbol at the bedside is not legally valid without the proper medical order. Additionally, a request from the next of kin, whether oral or written, is not a substitute for a signed physician's order.
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Nurse B arrives for his regular night shift at a care facility for the aged. Due to a family emergency, he has only slept for 3 hours since his last shift. One of Nurse B's aides calls in sick, and there is no one available to replace the aide that night. With no help accessible, Nurse B lifts an obese patient from a wheelchair into a bed alone. Short on time and assistance, Nurse B decides to forgo the patient's evening bath. Legally, what does Nurse B most likely face?
- A. Little risk of liability because he is doing his best under difficult circumstances
- B. Immediate termination for dereliction of duty
- C. Liability if a pattern of negligence is identified in his performance evaluation
- D. A high risk of liability for his actions
Correct Answer: D
Rationale: In this scenario, Nurse B faces a high risk of liability for his actions due to several factors. Working with insufficient resources, failing to adhere to policies and procedures, taking shortcuts, and working while highly stressed are all situations that increase the risk of liability. Nurse B's decision to lift an obese patient without assistance and skip the patient's evening bath due to time constraints and lack of help are clear examples of actions that can lead to legal consequences. Choices A, B, and C are incorrect because the circumstances described in the scenario indicate a higher likelihood of liability due to the factors mentioned above.
For which of the following is informed consent required?
- A. Ordering a liquid diet for a post-surgical patient
- B. Listening to a patient reveal his or her private, personal secrets
- C. Giving a patient saline solution to relieve dry nasal passages
- D. Asking a patient to complete a questionnaire for a research study on hospital practices
Correct Answer: D
Rationale: Informed consent is required when asking a patient to participate in a research study, as mentioned in choice D. Choices A, B, and C involve routine care measures that do not require specific informed consent. Ordering a liquid diet, providing saline solution for dry nasal passages, or listening to a patient's personal secrets are part of standard care and do not typically necessitate formal consent beyond general consent for treatment.
A nurse at a rehabilitation center is preparing a care plan for a 71-year-old post-stroke patient who has shown significant improvement in function and who is ready to return to the community. In the nurse's efforts to mobilize family caregiving, which of the following statements provides the most accurate criterion for inclusion in the category of 'family'?
- A. The patient's spouse, biological children, and closest friends
- B. Any unpaid person who has expressed sincere interest in the patient's condition and provided hands-on care since his admission to the facility
- C. Anyone who self-identifies as being a member of the patient's family
- D. Any individual who fulfills the patient's family functions
Correct Answer: D
Rationale: The most accurate criterion for inclusion in the category of 'family' when mobilizing family caregiving is identifying individuals who fulfill family functions. Choice D is the correct answer as it emphasizes the importance of individuals who perform essential family functions for the patient. This criterion is crucial as it prioritizes the practical support and care provided by individuals over biological relationships (Choice A), self-identification (Choice C), or willingness to provide care (Choice B), which may not always translate to fulfilling necessary family functions.
Mr. K has dementia. Having a good deal of money, he has a private room at Haven Nursing Home. He is a retired industrialist whose children and current wife are already squabbling bitterly over his estate. During visits, they often get into shouting matches that disturb the other residents and Mr. K himself. How should an administrator handle this family?
- A. Emphasize that they must behave civilly when visiting
- B. Have them set up separate visiting schedules
- C. Ask them to stay away
- D. Close Mr. K's door when they visit
Correct Answer: B
Rationale: There is little an administrator can do about this dysfunctional family's behavior, but Mr. K should not be upset by it, and the other residents deserve to be protected from shouting. By setting up separate visiting schedules, the family can continue to provide needed support for their husband and father. If they accidentally visit at the same time, the door can be kept closed until they leave.
What might a nurse suggest to help the grown children make the most of their limited incomes and time with their parents?
- A. Help them find nearby spots for picnics or other free outings
- B. Refer the family to a more appropriate practitioner
- C. Suggest they take out a second mortgage on the family house
- D. Encourage the entire family to participate in activities at Haven
Correct Answer: A
Rationale: A nurse, as a caring worker, may suggest helping the grown children find nearby spots for picnics or other free outings. This suggestion would allow the parents to get out of the facility and enjoy quality time with their children without any financial burden. While the family may also want to participate in activities at the facility, a picnic would provide a change of scenery. Referring the family to a more appropriate practitioner is not relevant to improving the limited incomes and time spent with the parents. Suggesting to take out a second mortgage on the family house could provide temporary financial relief but may not be the most suitable solution for maximizing time spent with the parents.