Nokea
Why might nurses not be the best choice to obtain informed consent from patients?
- A. Nurses may be tempted to influence the patient's decision in subtle ways.
- B. Nurses may not be able to answer some of the medical questions the patient asks.
- C. A signature obtained by anyone other than a physician will not stand up in court.
- D. Under the law, nurses are only allowed to act as witnesses to informed consent signatures.
Correct Answer: B
Rationale: Nurses may not have the medical expertise to answer all the questions that patients may have regarding their treatment, which is a crucial aspect of obtaining informed consent. While nurses should not influence a patient's decision, it is not a major reason why they should not obtain informed consent. Signatures obtained by nurses are legally binding, and although nurses often act as witnesses, there is no legal restriction preventing them from obtaining informed consent itself.
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A gerontological nurse is providing care at a local community health center that serves large black American and white American older adult populations. The nurse is working to develop culturally appropriate programs to meet each group's health needs and notes differences in health status between the groups. Which reason would the nurse most likely identify as accounting for the differences between the populations?
- A. High incidence of violent crime and sexually transmitted diseases in the black population
- B. Reliance on family for health care advice and rejection of formal service agencies in the white population
- C. Cultural preference for unconventional medical treatments like herbal remedies in the white population
- D. Lower standard of living and less access to health care services in the black population
Correct Answer: D
Rationale: The correct answer is D. Black older adults historically possess many health problems that have accumulated over a lifetime due to a poor standard of living and limited access to health care services. Option A is incorrect because it presents stereotypes about the black population that are not supported by evidence. Option B is incorrect because it generalizes the behavior of the white population without a strong basis. Option C is incorrect as it also generalizes the white population and does not address the disparities in health status between the two groups.
A nurse cares for an Asian American client with a fractured femur. During shift report, which statement by the nurse will another nurse challenge?
- A. The client has requested to wait to receive pain medication.
- B. The client does not want family to visit the room.
- C. The client is a recent immigrant to this country.
- D. The client is stoic and will not complain at all.
Correct Answer: D
Rationale: The correct answer is D. Stereotyping the client as stoic and unlikely to complain about pain is incorrect and can lead to inadequate pain management. It is essential for the nurse to assess and address the client's pain regardless of cultural background. Choices A, B, and C are not as critical as they respect the client's autonomy, cultural preferences regarding family visits, and provide relevant background information about the client's immigrant status.
Which of the following statements by family caregivers would the nurse consider most indicative of elder abuse?
- A. Mom can't handle her own money anymore, so I've had to take over her banking.
- B. When my dad starts wandering around the house, I give him sleeping pills until he calms down and falls asleep in his chair.
- C. My mother says she wants me to do everything for her, but I think it's better if she keeps on doing everything she's still capable of.
- D. I get so frustrated because my father used to be so competent, and now he can't even use a toilet.
Correct Answer: B
Rationale: The correct answer is B. The statement 'When my dad starts wandering around the house, I give him sleeping pills until he calms down and falls asleep in his chair' is most indicative of elder abuse as it involves the inappropriate use of chemical restraints. This practice can harm the elderly and is considered a form of abuse. Choices A, C, and D do not demonstrate elder abuse. Choice A may be a responsible action depending on the circumstances, choice C reflects a positive philosophy of care, and choice D expresses frustration but does not constitute abuse.
Nurse M obtains a signature on an informed consent form from Mr. Y, who is later shown to have a fluctuating level of mental competency. In this case, what is Nurse M's most likely legal position?
- A. Freedom from liability because Mr. Y signed the form
- B. Possibly liable for a violation of Mr. Y's rights
- C. Liable unless a malpractice insurance policy is in effect
- D. Not liable because no family member had a durable power of attorney
Correct Answer: B
Rationale: An informed consent may be considered invalid if the patient does not fully understand what he or she is signing. Patients with a fluctuating level of mental function are incapable of granting legally sound consent. Nurse M could be held liable for a violation of Mr. Y's rights as he did not have the capacity to provide informed consent. The presence of an insurance policy and the legal status of family members are irrelevant in this context and do not absolve Nurse M of potential liability.
How does a durable power of attorney differ from a power of attorney?
- A. It is granted by the court on behalf of an incompetent individual.
- B. It stays in effect if the individual granting it becomes incompetent.
- C. It goes into effect only after an individual becomes incompetent.
- D. It includes responsibility for managing an individual's financial assets.
Correct Answer: B
Rationale: A durable power of attorney allows competent individuals to appoint someone else to make decisions on their behalf in the event they become incompetent. Choice A is incorrect because a durable power of attorney is typically granted by the individual themselves, not the court. Choice C is incorrect as a durable power of attorney can be effective both before and after incompetency. Choice D is incorrect because managing financial assets is just one aspect of the authority granted by a power of attorney, not specifically for a durable power of attorney.