Nursing Elites

1. What is the best definition of ethics in nursing?

• A. advocating for the client
• B. knowing your scope of practice
• C. being able to differentiate right from wrong
• D. being willing to report violations

Correct answer: C

Rationale: Ethics in nursing refers to the moral principles that govern a nurse's behavior and decision-making. It involves being able to differentiate right from wrong, making choices that are morally sound, and upholding integrity in patient care. While advocating for the client (choice A) is an important aspect of nursing care, it does not fully encompass the broad concept of ethics. Knowing your scope of practice (choice B) is essential for safe and competent care but is not a comprehensive definition of ethics. Being willing to report violations (choice D) is part of ethical practice, but it is not the core definition of ethics in nursing.

2. A nurse who works in a medical care unit is told that she must float to the intensive care unit because of a short-staffing problem on that unit. The nurse reports to the unit and is assigned to three clients. The nurse is angry with the assignment because she believes that the assignment is more difficult than the assignment delegated to other nurses on the unit and because the intensive care unit nurses are each assigned only one client. The nurse should most appropriately take which action?

• A. Refuse to do the assignment
• B. Tell the nurse manager to call the nursing supervisor
• C. Return to the medical care unit and discuss the assignment with the nurse manager on that unit
• D. Ask the nurse manager of the intensive care unit to discuss the assignment

Correct answer: D

Rationale: In this scenario, the nurse feeling that the assignment is more difficult than what other nurses received should approach the nurse manager of the intensive care unit to discuss the assignment. By doing so, the nurse can seek clarification on the rationale for the assignment or confirm if it is genuinely more challenging. Refusing the assignment is not appropriate as it could impact patient care. Returning to the medical care unit would be considered client abandonment and does not directly address the conflict at hand. Instructing the nurse manager to involve the nursing supervisor is an aggressive approach that does not directly resolve the issue.

3. The laws enacted by states to provide immunity from liability to persons who provide emergency care at an accident scene are called:

• A. Good Samaritan laws.
• B. HIPAA.
• C. Patient Self-Determination Act (PSDA).
• D. OBRA.

Correct answer: A

Rationale: The correct answer is Good Samaritan laws. These laws protect individuals who provide voluntary emergency care from being held liable for any unintended injury or harm that may occur during the care. Good Samaritan laws encourage individuals to assist in emergencies without fear of legal repercussions. HIPAA, on the other hand, focuses on safeguarding patient information and privacy, ensuring confidentiality. The Patient Self-Determination Act (PSDA) pertains to a patient's rights to make decisions about their medical treatment and advance directives. OBRA, enacted in the late 1980s, aims to improve the quality of care in nursing homes and enhance residents' quality of life, focusing on nursing home reform and standards, which is not directly related to immunity for emergency care providers.

4. A nurse is assisting a new nursing graduate with organizational skills in delivering client care. The nurse determines that the new nursing graduate needs assistance with time management if the new graduate takes which action?

• A. Gathers supplies before beginning a task
• B. Allows time for unexpected tasks
• C. Prioritizes client needs and daily tasks
• D. Documents task completion and client information at the end of the day

Correct answer: A

Rationale: The correct answer is 'Gathers supplies before beginning a task.' This action indicates a lack of effective time management because gathering supplies before starting a task can lead to inefficiency and time wastage. Effective time management involves organizing tasks efficiently, which includes having all necessary supplies ready before initiating a task. Allowing time for unexpected tasks, prioritizing client needs and daily tasks, and documenting task completion and client information at the end of the day are all essential components of good time management practices. Therefore, the new nursing graduate should focus on improving the timing of supply gathering to enhance time management skills. The other choices are not indicative of poor time management; instead, they demonstrate important aspects of effective time management in client care delivery.

5. A small amount of bubbling is seen in the water seal of a pleural drainage system when a client coughs. What should the nurse do?

• A. Consider it a normal finding.
• B. Check the system for leaks.
• C. Clamp the chest tube.
• D. Change the drainage system.

Correct answer: A

Rationale: A small amount of bubbling is a normal finding in the water seal of a pleural drainage system when a client coughs. It is only a problem to find continuous, excessive bubbling in the water seal, which indicates a leak. Checking the system for leaks would be appropriate if there is continuous, excessive bubbling. Clamping the chest tube or changing the drainage system is not necessary in response to a small amount of bubbling during a cough, as this is considered a normal finding.

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