Nursing Elites

1. 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.

2. A nurse is working in an assisted living facility that has a culturally diverse older adult population. Which statement by the nurse best demonstrates cultural sensitivity?

• A. We need to ensure that both the minority population and the majority population have their health needs met.
• B. It's important to remember that minority groups do not usually express their pain explicitly.
• C. We need to build our knowledge of clients who belong to cultural and ethnic groups that we're not familiar with.
• D. We need to teach all clients that their health problems are not necessarily the result of punishment.

Correct answer: C

Rationale: The best demonstration of cultural sensitivity by the nurse is reflected in choice C. Building a knowledge base around cultural and ethnic groups is a crucial component of providing culturally sensitive care. Choice A creates an inaccurate dichotomy between 'minority' and 'majority' populations, which is not a culturally sensitive approach. Choice B incorrectly generalizes that minority groups do not usually express their pain explicitly, which is not true for all cultural groups. Choice D suggests imposing a different belief system on clients, which is not culturally sensitive and can undermine trust and rapport with older adult clients.

3. Nurse R works on the geriatric medicine unit of the university hospital and provides care for numerous older adult clients nearing the end of life, many of whom have no-code orders. Which of the following situations is incompatible with the legal requirements for a no-code order?

• A. A client who is mentally competent has declared his wish to have a no-code order despite the availability of treatment options for his condition.
• B. A client has expressed her desire to have a no-code order but her daughter is adamantly opposed to it.
• C. A client clearly tells the nurse her desire to have a no-code order, which the nurse documents at the bedside.
• D. A client has been in a coma and the family has decided to put in place a no-code order.

Correct answer: C

Rationale: The correct answer is C. No-code orders require a written and signed order by a physician. Therefore, a client expressing the desire for a no-code order to a nurse, without a documented physician's order, is incompatible with legal requirements. Choices A and B are not incompatible as competent clients can make their own decisions, regardless of treatment options or family opposition. Choice D is also not incompatible as family decisions can be made on behalf of incompetent clients.

4. 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.

5. An 81-year-old female client was diagnosed one year ago with Alzheimer's disease following a noticeable increase in confusion. She now possesses a durable power of attorney. Which of the following statements most accurately conveys an aspect of this legal arrangement?

• A. The parameters of the arrangement must be revisited if the client's condition declines.
• B. The arrangement was most likely initiated by court order.
• C. The client appointed someone to take care of her affairs in the event that she becomes incompetent.
• D. The family has control of logistical arrangements for the client but must gain court permission around financial affairs.

Correct answer: C

Rationale: The correct answer is C. Usually, a power of attorney becomes invalid if the individual granting it becomes incompetent, except in the case of a durable power of attorney. A durable power of attorney allows competent individuals to appoint someone to make decisions on their behalf in the event that they become incompetent. This legal arrangement is recommended for individuals with conditions like Alzheimer's disease where competency decline can be anticipated. It is not initiated by the court, unlike guardianship. A durable power of attorney encompasses both logistical and financial affairs, providing authority to the appointed person to act on behalf of the individual should they become incapacitated. Choices A, B, and D are incorrect because they do not accurately describe the purpose and nature of a durable power of attorney in the context of planning for incompetency due to conditions like Alzheimer's disease.

Similar Questions