Nursing Elites

1. The nurse and a colleague are on the elevator after their shift, and they hear a group of healthcare providers discussing a recent client scenario. Which client right might be breached?

• A. right to refuse treatment
• B. right to continuity of care
• C. right to confidentiality
• D. right to reasonable responses to requests

Correct answer: C

Rationale: The right to confidentiality of client information might be breached when client care situations are discussed in public areas or without regard to maintaining the information as private and confidential. In this scenario, the conversation on the elevator could lead to a breach of the client's right to confidentiality. The other options, such as the right to refuse treatment, right to continuity of care, and right to reasonable responses to requests, are not being breached in this instance, making them incorrect choices.

2. How is the information documented on incident reports used?

• A. to analyze risk categories
• B. to ensure compliance with regulations
• C. to identify staff's educational needs
• D. all of the above

Correct answer: D

Rationale: The information documented on incident reports is used for various purposes, including analyzing risk categories, ensuring compliance with regulations, and identifying staff's educational needs. Incident reports provide valuable data that can be utilized in risk management, quality monitoring, and improvement programs. Therefore, the correct answer is 'all of the above.' Choices A, B, and C are all correct as incident reports are used for analyzing risk categories, ensuring compliance with regulations, and identifying staff's educational needs, respectively. Thus, the most comprehensive answer is 'all of the above.'

3. A Hispanic client brings her father to the clinic because he is becoming more forgetful. He is diagnosed with Alzheimer's disease. The woman tells the nurse that she wants to try ginkgo biloba for her father before using prescription medications. Which of the following is an appropriate response by the nurse?

• A. "It is wiser to start with a prescription."?
• B. "That herb may not be effective for your father."?
• C. "You can't expect an herb to cure Alzheimer's."?
• D. "I will let the physician know of your wishes."?

Correct answer: D

Rationale: The appropriate response is to acknowledge the client's wishes and communicate them to the physician for consideration. It is important to be culturally sensitive and respect the client's preferences. Ginkgo biloba has shown some benefits in treating dementia, so it is essential to involve the healthcare provider in the decision-making process. Choices A, B, and C are dismissive and fail to consider the client's perspective and cultural beliefs. It is crucial for healthcare professionals to engage in open communication and collaboration with clients to provide patient-centered care.

4. What is a predisposing factor for cancer of the tongue?

• A. tobacco use
• B. obesity
• C. sun exposure
• D. eating sweets

Correct answer: A

Rationale: Tobacco use is a well-established predisposing factor for cancer of the tongue. Smoking or chewing tobacco can lead to the development of oral cancers, including those affecting the tongue. Obesity, sun exposure, and eating sweets are not directly linked to an increased risk of tongue cancer. Obesity may be associated with other types of cancer, sun exposure can lead to skin cancer, and eating sweets is not a known risk factor for tongue cancer. Therefore, the correct answer is tobacco use, as it has a strong association with the development of tongue cancer, making it a significant predisposing factor.

5. A health care provider informs a nurse that the husband of an unconscious client with terminal cancer will not grant permission for a do-not-resuscitate (DNR) order. The health care provider tells the nurse to perform a 'slow code' and let the client 'rest in peace' if she stops breathing. How should the nurse respond?

• A. Telling the health care provider that the client would probably want to die in peace
• B. Telling the health care provider that if the client stops breathing, the health care provider will be called before any other actions are taken
• C. Telling the health care provider that all of the nurses on the unit agree with this plan
• D. Telling the health care provider that 'slow codes' are not acceptable

Correct answer: D

Rationale: The nurse may not violate a family's request regarding the client's treatment plan. A 'slow code' is not acceptable, and the nurse should state this to the health care provider. The definition of a 'slow code' varies among health care facilities and personnel and could be interpreted as not performing resuscitative procedures as quickly as a competent person would. Resuscitative procedures that are performed more slowly than recommended by the American Heart Association are below the standard of care and could therefore serve as the basis for a lawsuit. The other options are inappropriate: Option A is speculative and does not address the issue directly; Option B does not challenge the unethical practice of a 'slow code'; Option C is irrelevant and does not address the ethical concerns raised by the health care provider's request.

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