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. Mr. K has dementia. Having a good deal of money, he has a private room at Haven Nursing Home. He is a retired industrialist whose children and current wife are already squabbling bitterly over his estate. During visits, they often get into shouting matches that disturb the other residents and Mr. K himself. How should an administrator handle this family?

• A. Emphasize that they must behave civilly when visiting
• B. Have them set up separate visiting schedules
• C. Ask them to stay away
• D. Close Mr. K's door when they visit

Correct answer: B

Rationale: There is little an administrator can do about this dysfunctional family's behavior, but Mr. K should not be upset by it, and the other residents deserve to be protected from shouting. By setting up separate visiting schedules, the family can continue to provide needed support for their husband and father. If they accidentally visit at the same time, the door can be kept closed until they leave.

3. A gerontological nurse is providing care at a local community health center that serves large black American and white American older adult populations. The nurse is working to develop culturally appropriate programs to meet each group's health needs and notes differences in health status between the groups. Which reason would the nurse most likely identify as accounting for the differences between the populations?

• A. High incidence of violent crime and sexually transmitted diseases in the black population
• B. Reliance on family for health care advice and rejection of formal service agencies in the white population
• C. Cultural preference for unconventional medical treatments like herbal remedies in the white population
• D. Lower standard of living and less access to health care services in the black population

Correct answer: D

Rationale: The correct answer is D. Black older adults historically possess many health problems that have accumulated over a lifetime due to a poor standard of living and limited access to health care services. Option A is incorrect because it presents stereotypes about the black population that are not supported by evidence. Option B is incorrect because it generalizes the behavior of the white population without a strong basis. Option C is incorrect as it also generalizes the white population and does not address the disparities in health status between the two groups.

4. How might the nursing home's social worker help Ms. O's friends in visiting her?

• A. The social worker should defer to the nursing staff
• B. Help her friends find easier transportation
• C. Tell her to make friends at the dialysis center
• D. Ask other residents' families to bring her friends with them

Correct answer: B

Rationale: The correct answer is B. Ms. O's friends, who are elderly and cannot drive, ride buses to visit her. The social worker can help by finding easier transportation options for them. Not having family around, friends' visits can significantly impact Ms. O's well-being. It may be challenging for the friends to ask for help themselves, so the social worker can reach out to volunteer groups for assistance. Making friends at the dialysis center might not be feasible due to the nature of treatments. Asking other residents' families to bring her friends could burden them further and might deter them from helping. It's important to consider the friends' convenience and emotional support for Ms. O.

5. A visiting nurse becomes concerned about a caregiver daughter. Although she does not seem overburdened, she may be drinking too much. The recycling bin contains many wine bottles, and visitors come to the home. What action should the nurse take?

• A. Direct the daughter to a local Alcoholics Anonymous chapter
• B. Ignore the signs unless they interfere with caregiving
• C. Find a new caregiver in the family or outside of it
• D. Assess the daughter's motivation and ability to provide care

Correct answer: D

Rationale: The correct action for the nurse to take in this situation is to assess the daughter's motivation and ability to provide care. The nurse should not jump to conclusions based solely on the presence of wine bottles in the recycling bin. It is important to understand the daughter's overall capacity for caregiving and if her potential alcohol consumption is affecting her ability to provide care. Directing the daughter to Alcoholics Anonymous without a thorough assessment may not be appropriate at this stage. Ignoring the signs or immediately finding a new caregiver without understanding the daughter's situation may not address the underlying issue. Therefore, assessing the daughter's motivation and caregiving capabilities is the most appropriate initial step for the nurse.

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