Nursing Elites

1. Which of the following is an example of a breach of a client's right to privacy?

• A. A nurse who is not caring for the client reads the client's personal information in the chart
• B. A client is not allowed to keep a copy of their original medical record
• C. A nurse files an incident report about a client that is reviewed with all staff at a meeting
• D. A client's photograph is used without permission for the hospital newsletter

Correct answer: D

Rationale: A breach of a client's right to privacy can occur when their personal information is used or disclosed without their consent. In this scenario, using a client's photograph without permission for the hospital newsletter violates their privacy rights. It is important to respect a client's confidentiality and seek their consent before using their personal information. Choices A, B, and C do not directly relate to breaching a client's right to privacy. Reading a client's personal information in their chart, not allowing a client to keep a copy of their medical record, and filing an incident report about a client do not necessarily violate their privacy rights as long as the information is handled appropriately and within legal and ethical boundaries.

2. Employee health test results reveal a tuberculosis (TB) skin test of 16-mm induration and a negative chest x-ray for a staff nurse working on the pulmonary unit. The nurse has no symptoms of TB. Which information should the occupational health nurse plan to teach the staff nurse?

• A. Standard four-drug therapy for TB
• B. Need for annual repeat TB skin testing
• C. Use and side effects of isoniazid (INH)
• D. Bacille Calmette-Gurin (BCG) vaccine

Correct answer: C

Rationale: The nurse is considered to have a latent TB infection and should be treated with INH daily for 6 to 9 months. The four-drug therapy would be appropriate if the nurse had active TB. TB skin testing is not done for individuals who have already had a positive skin test. BCG vaccine is not used in the United States for TB and would not be helpful for this individual, who already has a TB infection.

3. A nurse is caring for an in-patient client in the hospital who is from another country and who fasts for temporary periods in order to promote his own spiritual growth. The nurse responds by saying, 'You need to eat something while you are here. Food and proper nutrition are extremely important for your health.' What social philosophy is the nurse demonstrating?

• A. Ethnocentrism
• B. Relativism
• C. Stereotyping
• D. Xenocentrism

Correct answer: A

Rationale: The nurse's response reflects ethnocentrism, a belief that one's own cultural practices are superior to others. Ethnocentrism involves viewing one's own culture as the standard by which all others should be judged. In this scenario, the nurse's insistence that the client needs to eat disregards the client's cultural and spiritual beliefs, considering only the nurse's perspective as valid. B: Relativism is the recognition and acceptance of cultural differences without judgment. The nurse's behavior does not align with relativism as there is a lack of understanding and acceptance of the client's cultural practices. C: Stereotyping involves making assumptions about individuals based on predefined characteristics. While the nurse may have made assumptions, the core issue in this scenario is the belief in the superiority of one's own cultural practices. D: Xenocentrism is the opposite of ethnocentrism, where one perceives other cultures as superior to their own. The nurse's actions are not driven by a belief in the superiority of the client's culture but rather by a belief in the superiority of her own cultural practices.

4. A victim of a gunshot wound to the abdomen has been admitted to the hospital, accompanied by a police officer. When questioned, the officer states that the patient is a suspect in a homicide, which occurred as part of the same incident. A small child was killed as the result of a stray bullet. The patient is combative, yells that he's in pain and demands medication. What is your most appropriate response?

• A. Tell him you'll take care of him after your other patients
• B. Reinforce restraints
• C. Perform a pain assessment and administer pain medication
• D. Ask the officer for more details of the incident

Correct answer: C

Rationale: The most appropriate and caring response is to perform a pain assessment and administer the pain medication that has been ordered. Regardless of personal feelings about any given situation, the nurse's responsibility is to provide unbiased, appropriate, and supportive care, as stated in the American Nurses Association (ANA) Code of Ethics. Choice A is not appropriate as it disregards the patient's immediate need for pain relief. Choice B may escalate the situation and is not the priority in this case. Choice D is not the immediate action needed to address the patient's pain and distress.

5. Mr. Freeman has difficulty getting out of bed. The nurse should encourage Mr. Freeman to ______________.

• A. ask for assistance before getting out of bed.
• B. remain in bed because it is safer and he will not fall.
• C. instruct him to stand up quickly from the bed.
• D. lean forward and push up and off the bed.

Correct answer: A

Rationale: The nurse should encourage Mr. Freeman to use his call bell and ask for assistance before getting out of bed. This can prevent him from falling. Patients should not stay in bed; they should be encouraged to get out of bed as much as possible to prevent complications like pressure ulcers and muscle weakness. Instructing a patient to stand up quickly from the bed is unsafe as it can lead to dizziness and falls. Similarly, leaning forward and pushing off the bed can increase the risk of falls and should be avoided. Asking for assistance is the safest and most appropriate option to ensure patient safety and prevent accidents.

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