which of the following situations can be identified as an ethical dilemma

ATI LPN

ATI PN Comprehensive Predictor 2023 with NGN

1. Which of the following situations can be identified as an ethical dilemma?

A. A nurse demonstrates signs of chemical impairment
B. A family has conflicting feelings about tube feeding for their terminally ill father
C. A nurse overhears a colleague threatening to restrain a patient if they do not stay in bed
D. A client with terminal cancer hesitates to name their spouse as power of attorney

Correct answer: B

Rationale: The correct answer is B. Ethical dilemmas involve conflicting values or feelings. In this situation, the family is conflicted about tube feeding for their terminally ill father, which presents a moral and ethical challenge. Choices A, C, and D do not represent ethical dilemmas. Choice A involves a nurse's impairment, which is a different issue. Choice C involves a nurse's observation of a colleague's threat, which is a patient safety concern. Choice D involves a client's hesitation in naming a spouse as power of attorney, which is a legal and decision-making issue, not necessarily an ethical dilemma.

2. A client who is immobile needs interventions to prevent contractures. Which of the following interventions is appropriate?

A. Aligning a trochanter wedge between the client's legs.
B. Placing a towel roll under the client's neck.
C. Applying an orthotic to the client's foot.
D. Positioning a pillow under the client's knees.

Correct answer: C

Rationale: Applying an orthotic to the client's foot is the appropriate intervention to prevent contractures in an immobile client. An orthotic helps maintain proper alignment and prevents the development of contractures by keeping the foot in the correct position. Choices A, B, and D are incorrect because a trochanter wedge, towel roll under the neck, and pillow under the knees are not specific interventions for preventing contractures in an immobile client.

3. A client is reinforcing teaching with a nurse about how to use an incentive spirometer. Which of the following actions by the client indicates an understanding of the teaching?

A. The client exhales deeply before inhaling
B. The client attempts to elevate the cylinder by inhaling deeply
C. The client inhales quickly through the spirometer
D. The client inhales several short breaths

Correct answer: B

Rationale: The correct answer is B because inhaling deeply and slowly elevates the cylinder on the spirometer, promoting lung expansion. Choice A is incorrect as exhaling deeply before inhaling is not the correct technique for using an incentive spirometer. Choice C is incorrect as inhaling quickly through the spirometer does not promote optimal lung expansion. Choice D is incorrect as inhaling several short breaths does not facilitate the proper use of an incentive spirometer.

4. What is an early sign indicating the need for suctioning a client's tracheostomy?

A. Irritability
B. Hypotension
C. Flushing
D. Bradycardia

Correct answer: A

Rationale: Irritability is a crucial early sign that a client with a tracheostomy may require suctioning. Irritability could indicate a lack of oxygenation due to the airway blockage, prompting the need for suctioning to clear the airway. Hypotension, flushing, and bradycardia are not typically direct indicators for suctioning a tracheostomy. Hypotension may suggest hemodynamic instability, flushing could be related to autonomic responses, and bradycardia might indicate a cardiac issue rather than the need for suctioning.

5. What are the signs of an acute myocardial infarction?

A. Chest pain radiating to the arm and shortness of breath
B. Nausea, vomiting, and high fever
C. Headache, confusion, and low blood pressure
D. Increased heart rate and bradycardia

Correct answer: A

Rationale: The correct answer is A: Chest pain radiating to the arm and shortness of breath. These are classic signs of an acute myocardial infarction. Choice B is incorrect because nausea, vomiting, and high fever are not typical signs of a heart attack. Choice C is incorrect as headache, confusion, and low blood pressure are not specific to myocardial infarction. Choice D is incorrect because an acute myocardial infarction typically presents with an increased heart rate, not bradycardia.