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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.
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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.
While teaching an Asian patient regarding prenatal care, the nurse notes that the patient refuses to make eye contact. Which is the most likely cause for this behavior?
- A. A submissive attitude
- B. Lack of understanding
- C. Embarrassment about the subject
- D. Cultural beliefs about eye contact
Correct Answer: D
Rationale: In many Asian cultures, avoiding eye contact can be a sign of respect, modesty, or a way to show deference to authority figures. Making direct eye contact during a conversation, especially with someone in a position of authority like a healthcare provider, can be seen as disrespectful or confrontational. Understanding and respecting these cultural beliefs is crucial when providing care to patients from diverse backgrounds. It is important for healthcare providers to be aware of these cultural differences and adjust their communication styles accordingly to ensure effective and culturally sensitive care.
Which patient could safely be cared for by a certified nurse-midwife?
- A. Gravida 3, para 2, with no complications
- B. Gravida 1, para 0, with mild hypertension
- C. Gravida 2, para 1, with insulin-dependent diabetes N R I G B.C M U S N T O
- D. Gravida 1, para 0, with borderline pelvic measurements
Correct Answer: A
Rationale: A patient who is Gravida 3, para 2, with no complications can safely be cared for by a certified nurse-midwife. This patient has had two previous pregnancies, both resulting in successful deliveries, and is currently not experiencing any complications. Nurse-midwives are trained to provide care for low-risk pregnancies and deliveries, making this patient an appropriate candidate for their care. Patients with mild hypertension (choice B), insulin-dependent diabetes (choice C), or borderline pelvic measurements (choice D) would likely require additional monitoring and potential intervention beyond the scope of practice of a certified nurse-midwife.
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.
What nursing intervention would the nurse include in the preoperative care plan for a patient scheduled for an outpatient lumpectomy of a fibroadenoma?
- A. Administer pain and antiemetic medications.
- B. Help the patient arrange for a cab home after the procedure.
- C. Advise the patient to avoid food or drink for 2 hours before surgery.
- D. Review discharge instructions.
Correct Answer: C
Rationale: It is essential to advise the patient to avoid food or drink for at least 2 hours before surgery to reduce the risk of aspiration during the procedure. An empty stomach helps prevent vomiting and aspiration of stomach contents that could potentially lead to respiratory complications during the surgical procedure. This is a crucial preoperative nursing intervention to ensure patient safety and preparation for the lumpectomy surgery. Administering pain and antiemetic medications, arranging for transportation home, and reviewing discharge instructions are important aspects of care but do not directly impact the patient's safety during the procedure like fasting before surgery does.