Nursing Elites

1. Nurse B arrives for his regular night shift at a care facility for the aged. Due to a family emergency, he has only slept for 3 hours since his last shift. One of Nurse B's aides calls in sick, and there is no one available to replace the aide that night. With no help accessible, Nurse B lifts an obese patient from a wheelchair into a bed alone. Short on time and assistance, Nurse B decides to forgo the patient's evening bath. Legally, what does Nurse B most likely face?

• A. Little risk of liability because he is doing his best under difficult circumstances
• B. Immediate termination for dereliction of duty
• C. Liability if a pattern of negligence is identified in his performance evaluation
• D. A high risk of liability for his actions

Correct answer: D

Rationale: In this scenario, Nurse B faces a high risk of liability for his actions due to several factors. Working with insufficient resources, failing to adhere to policies and procedures, taking shortcuts, and working while highly stressed are all situations that increase the risk of liability. Nurse B's decision to lift an obese patient without assistance and skip the patient's evening bath due to time constraints and lack of help are clear examples of actions that can lead to legal consequences. Choices A, B, and C are incorrect because the circumstances described in the scenario indicate a higher likelihood of liability due to the factors mentioned above.

2. Which of the following aspects of gerontological nursing would be most likely classified under private law?

• A. The regulation of who may call himself or herself a 'nurse'
• B. The contract between an older adult resident of a care facility and the owners of the facility
• C. The legal criteria for declaring an individual mentally incompetent
• D. The criminal consequences for instances of elder abuse

Correct answer: B

Rationale: The correct answer is B because private law deals with relationships between individuals and organizations, such as the contract between an individual and the care facility. Choices A, C, and D are not classified under private law. Choice A pertains to professional regulation and is a matter of public law. Choice C involves legal criteria and decision-making related to mental competence, falling under public law. Choice D concerns criminal consequences, which are also part of public law.

3. A nurse is reviewing the client population of a local community health center and identifying the health care needs of the group. The nurse decides to develop a screening program for hypertension. Which client population would the nurse most likely be working with?

• A. A seniors' group based at a Jewish community center.
• B. A Native American reservation/Canadian aboriginal reserve.
• C. A predominantly Chinese-American neighborhood.
• D. A minimum-security prison serving young, rehabilitating offenders.

Correct answer: B

Rationale: Hypertension is disproportionately high among Native American/First Nations clients. This condition is not noted to be a major health problem among Jewish Americans, prisoners, or Americans of Chinese ancestry. Developing a screening program for hypertension in a Native American reservation/Canadian aboriginal reserve would be most appropriate based on the prevalence of the condition in this population.

4. Mrs. W, aged 82, resides with her son and daughter-in-law who are finding it challenging to provide adequate care while maintaining their careers and home life. During a homecare visit, Mrs. W tells the nurse that, 'My children's generation doesn't know how good they've got it; when I was younger we all had to take care of our parents, and for a lot longer than most people do now.' Which of the following statements most accurately underlies the response that the nurse will provide to Mrs. W?

• A. The increasing prevalence of chronic illnesses means that there are indeed fewer old-old adults than there were in earlier generations.
• B. The increasing acceptance of long-term care means that the caregiving burden of the son and daughter-in-law's generation is lighter than that of Mrs. W's generation.
• C. More older people are living longer and receiving care in the community than when Mrs. W was in her middle-adult years.
• D. The caregiving needs of the old-old are increasing but these needs are more commonly met in institutional settings rather than in the community.

Correct answer: C

Rationale: The correct answer is C because people are living longer and receiving more of their care in the community than in years past. This reflects the current trend where older individuals tend to receive care in community settings rather than institutional ones. Choices A, B, and D are incorrect because they do not align with the reality that more older people today are living longer and being cared for in the community.

5. A nurse is determining ways to address ethnic diversity among clients being provided care. Which action would be the most direct way for the nurse to do this?

• A. Explain how cultural backgrounds influence health beliefs and practices.
• B. Provide culturally sensitive care that respects clients' traditions.
• C. Listen to the life stories of clients to understand their cultural influences.
• D. Participate in cultural competency training and workshops.

Correct answer: C

Rationale: Listening to the life stories of clients is an effective way for nurses to understand the cultural influences that shape their beliefs and practices. By actively listening, nurses can gain insight into the clients' backgrounds, values, and preferences, allowing them to provide more personalized and culturally sensitive care. Choices A, B, and D are not as direct as listening to the life stories of clients. While explaining how cultural backgrounds influence health beliefs and practices is important, directly listening to clients' life stories provides a deeper understanding of their individual cultural influences.

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