Nokea
Who should document care?
- A. The LPNs should document the care that they provided and the care that was given by unlicensed assistive staff.
- B. The registered nurse must document all of the care that is provided by the nursing assistants because they are accountable for all care.
- C. All staff members should document all of the care that they have provided.
- D. All staff should document all of the care that they have provided but the registered nurse, as the only independent practitioner, signs it.
Correct Answer: C
Rationale: All staff members should document the care they provided as part of their accountability and to ensure accurate and comprehensive records. In healthcare settings, it is essential for all staff to document the care they deliver for continuity of care and legal purposes. The registered nurse may sign off on the documentation for oversight purposes, but the responsibility of documenting care extends to all staff involved in patient care. Choices A and B incorrectly limit the responsibility to specific roles, while choice D inaccurately suggests that only the registered nurse signs off on the documentation, overlooking the importance of comprehensive documentation by all staff members involved.
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A nurse is caring for a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue the client's feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make?
- A. You should contact the provider about your wishes for your family member.
- B. We'll need to have the nursing supervisor review the client's advance directives.
- C. You should speak with the facility's ethics committee about your concerns.
- D. As the health care surrogate, the client's partner can make this decision.
Correct Answer: D
Rationale: The correct response is D because the health care surrogate, as designated by the client, has the legal authority to make healthcare decisions on behalf of the client when they are unable to do so. This authority includes decisions about treatment continuation or withdrawal. Option A is incorrect as the family member's wishes do not override the legal authority of the health care surrogate. Option B is not the most appropriate action in this situation as the advance directives are already clear by the designation of a health care surrogate. Option C is not necessary at this stage since the health care surrogate can make the decision without involving the ethics committee.
What is a major benefit of electronic health records (EHRs)?
- A. Increased paperwork
- B. Better coordination of care
- C. Higher risk of data breaches
- D. More manual data entry
Correct Answer: B
Rationale: The major benefit of electronic health records (EHRs) is better coordination of care. EHRs allow healthcare providers to access and share patient information more efficiently, leading to improved coordination and continuity of care. Choice A, increased paperwork, is incorrect as EHRs aim to reduce paperwork by digitizing and centralizing health records. Choice C, higher risk of data breaches, is incorrect as EHRs have security measures in place to protect patient data. Choice D, more manual data entry, is incorrect as EHRs aim to automate and streamline data entry processes.
A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first?
- A. Remove the restraints from the client's wrists
- B. Review the chart for nonrestraint alternatives for agitation
- C. Speak with the AP about the incident
- D. Inform the unit manager of the incident
Correct Answer: A
Rationale: The correct action for the nurse to take first is to remove the restraints from the client's wrists. Restraints should not be applied without a prescription due to the risk of harm to the client. Removing the restraints promptly is a priority to ensure the client's safety. Reviewing nonrestraint alternatives, speaking with the AP, and informing the unit manager can follow after ensuring the client's immediate safety by removing the restraints.
A client with a tumor refuses surgery, but the client's partner wants it. Which is the deciding factor in determining if the surgery will be done?
- A. Whether the partner is the client's durable power of attorney for healthcare
- B. Whether the client understands the risk of refusing the procedure
- C. Whether the client's refusal is based on religious belief
- D. Whether the facility's ethical committee reaches a consensus on the case
Correct Answer: B
Rationale: The correct answer is B because the client's understanding of the risks involved in refusing the surgery is crucial in determining the course of action. In this scenario, the client's autonomy and decision-making capacity take precedence. Choice A is not directly relevant to the decision-making process regarding surgery. Choice C, religious beliefs, may influence the decision but should not be the determining factor in this case. Choice D involving the facility's ethical committee is not typically involved in individual patient care decisions.
A nurse is preparing a client for surgery. The client has signed the consent form but tells the nurse that she has reconsidered because she is worried about the pain. Which of the following responses by the nurse is appropriate?
- A. If you have the procedure now, you won't have to deal with pain and disability later.
- B. You'll be fine. You'll receive a prescription for pain medication.
- C. Why didn't you discuss your concerns with your provider?
- D. I understand and it's not too late to change your mind.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.