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. During a home visit, a nurse notes that an 80-year-old female patient's blood pressure is 166/99 despite the recent introduction of a diuretic to her medication regimen. The patient admits that her son refuses to give her the diuretic because it has precipitated incontinence episodes and states, 'He gets so furious when I soil myself.' What action should the nurse prioritize in this potential case of elder abuse?

• A. Improving or salvaging the family dynamics
• B. Teaching the son why his actions are inappropriate
• C. Initiating legal action
• D. Taking measures to protect the patient's safety

Correct answer: D

Rationale: In this potential case of elder abuse, the nurse's priority should be taking measures to protect the patient's safety. The patient's health and well-being are at risk due to the son's refusal to administer the diuretic, which can lead to serious health complications. While improving family dynamics (choice A), educating the son (choice B), and legal actions (choice C) may be necessary in the long run, the immediate concern is ensuring the patient's safety and well-being.

3. A nurse is performing a health history on a client who identifies as Native American/First Nations. Based on familial history and racial disparities, for which health issue should the nurse prepare to monitor in this client?

• A. autoimmune disorders
• B. heart disease
• C. Alzheimer's disease
• D. lung cancer

Correct answer: B

Rationale: The correct answer is B: heart disease. Heart disease is a major health issue among Native American/First Nations populations, along with diabetes, malignant neoplasm, and unintentional injuries, contributing to a decreased lifespan. Autoimmune disorders, Alzheimer's disease, and lung cancer are not the primary health concerns that the nurse should monitor for in this client. By understanding the prevalent health issues in this population, the nurse can provide targeted care and interventions to promote better health outcomes.

4. 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.

5. 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.

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