Nursing Elites

1. 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.

2. 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.

3. How does guardianship differ from power of attorney?

• A. The court appoints a guardian; an individual grants a power of attorney to someone else to make decisions on his or her behalf.
• B. Guardianship is legally binding whether or not an individual is competent; power of attorney applies only to the incompetent.
• C. Courts monitor the actions of those executing a power of attorney, but guardians are free to act on behalf of another as long as standards of 'reasonable prudence' are met.
• D. Guardianship stays in effect for one calendar year and must be renewed annually; power of attorney stays in effect until one or both parties choose to revoke it.

Correct answer: A

Rationale: The correct answer is A. The key difference between guardianship and power of attorney is that the court appoints a guardian to make decisions on behalf of an individual who is deemed incompetent, while an individual grants a power of attorney to someone else to make decisions on their behalf when they are competent. Choice B is incorrect because both guardianship and power of attorney can apply to individuals who are competent or incompetent. Choice C is incorrect as guardians, like those with power of attorney, must act in the best interest of the individual they represent, and the level of oversight can vary. Choice D is incorrect as guardianship and power of attorney do not have fixed time limits; they remain in effect until revoked or ended by the appropriate legal process.

4. 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.

5. Based on the information provided, what can be inferred about the nurse who has been working for several years in a long-term care facility with many Middle Eastern residents?

• A. The nurse's knowledge and skills provide expected care for clients in this demographic.
• B. The nurse is knowledgeable about Middle Eastern culture and respects and values providing culturally competent care.
• C. The nurse is attempting to overcompensate for cultural blindness and ethnocentrism within the community.
• D. This employment has allowed the nurse to demonstrate ethnic identity and cultural bias to a specific group of people.

Correct answer: B

Rationale: The nurse in the scenario is likely knowledgeable about Middle Eastern culture and values providing culturally competent care to the residents. This inference can be made based on the nurse being well-respected and effective in providing care to this population. Choice A is incorrect because it only focuses on the nurse's knowledge and skills, not specifically about cultural competence. Choice C is incorrect as there is no indication of overcompensation; the nurse is described as effective and well-respected. Choice D is incorrect as there is no evidence to suggest that the nurse is demonstrating ethnic identity or cultural bias, but rather respecting and providing care tailored to the cultural needs of the residents.

Similar Questions