Nursing Elites

1. What is a standard of care?

• A. A relationship in which a nurse has assumed responsibility for the care of a patient
• B. A policy or procedure established by a health care agency or professional association
• C. The norm for what a reasonable individual would do in a similar circumstance
• D. A public law that, if violated, can result in liability for the nurse

Correct answer: C

Rationale: A standard of care is the level of care that a reasonably prudent person with similar training and experience would provide in a similar circumstance. Choice A is incorrect because it describes the nurse-patient relationship. Choice B is incorrect as it refers to specific policies or procedures. Choice D is incorrect as it describes a law rather than the expected level of care.

2. A nurse working with a population of black clients is cognizant that some health conditions are more prevalent in this population than in the white population and is working to address them. Which health assessment would be the priority for this client population?

• A. Mandating different lifestyle choices because of a lower life expectancy
• B. Monitoring their blood pressure because of a blunted nocturnal response
• C. Examining their buccal mucosa because black skin color can complicate the use of skin color for assessment
• D. Monitoring for HIV/AIDS as this is a leading cause of death among black clients

Correct answer: B

Rationale: Hypertension is the most prevalent health problem among black Americans. A blunted nocturnal response is one factor responsible for this problem.

3. How does the doctrine of respondent superior affect nurses?

• A. Liable for injury resulting from advice given to a member of a patient's family
• B. Responsible for double-checking the doses of medication ordered by a physician
• C. Responsible for the actions of the staff they supervise
• D. Obligated to obtain informed consent for any diagnostic procedure

Correct answer: C

Rationale: The correct answer is C. The doctrine of respondent superior holds that supervisors are accountable not only for their own actions but also for the actions of the staff they oversee. This means that nurses, as supervisors, are responsible for ensuring that the actions of their staff comply with established protocols and standards of care. Choices A, B, and D are incorrect because they do not directly relate to the principle of respondent superior. Nurses may have other responsibilities related to giving advice, medication administration, and obtaining consent, but the doctrine of respondent superior specifically pertains to the accountability of supervisors for the actions of their subordinates.

4. Which of the following is required in order for a healthcare provider to be legally justified in not attempting to save a client's life?

• A. A 'Do Not Resuscitate' (DNR) statement on the patient's care plan
• B. A 'No-Code' sign or symbol placed at the patient's bedside
• C. A 'No-Code' order written and signed on the physician's order sheet
• D. The next of kin's request for 'Do Not Resuscitate' orally or in writing

Correct answer: C

Rationale: To legally justify not attempting to save a client's life, a healthcare provider must have a 'No-Code' order written and signed on the physician's order sheet. Unless there is a specific order stating that resuscitation should not be performed, failure to do so can be considered negligence. A 'Do Not Resuscitate' statement on the care plan or a symbol at the bedside is not legally valid without the proper medical order. Additionally, a request from the next of kin, whether oral or written, is not a substitute for a signed physician's order.

5. An older adult client tells the nurse that blockage of qi in one of the body's meridians is causing severe headaches. The health care provider has diagnosed migraines and has prescribed a triptan drug. Which action would be most appropriate for the nurse to implement?

• A. Suggest that the prescribed medicine may stimulate the flow of qi
• B. Explain the vasoconstrictive and serotonin-moderating action of triptan
• C. Instruct the client to take as many doses as needed for relief
• D. Caution the client that the headaches will grow worse if the client fails to take the medication

Correct answer: A

Rationale: Qi is the life force that circulates through the body in invisible pathways called meridians. In this scenario, the client believes that the blockage of qi is causing severe headaches. While explaining the scientific principles underlying the drug action could be valuable, it's crucial to consider the client's belief system. Therefore, the most appropriate response is to suggest that the prescribed medicine may stimulate the flow of qi, aligning with the client's perspective. Choice B, explaining the vasoconstrictive and serotonin-moderating action of triptan, does not address the client's concerns about qi blockage. Choice C, instructing the client to take as many doses as needed, can lead to potential medication misuse. Choice D, cautioning the client about worsening headaches without medication, may induce fear and hinder effective communication with the client.

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