A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed:

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Ethics & Issues in Contemporary Nursing Questions

Question 1 of 9

A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed:

Correct Answer: B

Rationale: The correct answer is B: shock or rejection. This phase of reality shock is characterized by feelings of being overwhelmed, confused, and unsure of how to proceed despite having knowledge. The novice nurse is experiencing a sense of rejection towards the situation due to the gap between theoretical knowledge and practical application. This phase is common among new healthcare professionals as they transition from academic learning to real-world clinical practice. A: Honeymoon phase refers to the initial period of excitement and enthusiasm in a new role. C: Recovery phase is when the individual starts to adapt and become more comfortable with the new role. D: Resolution phase is the final stage where the individual fully integrates into the role and becomes confident and competent. In this scenario, the novice nurse is clearly struggling and feeling overwhelmed, indicating that they are in the shock or rejection phase, making choice B the correct answer.

Question 2 of 9

A patient informs the nurse, "I can't sit in the yard for even 10 minutes without my skin turning red and tender." The nurse would assess for the use of which complementary alternative medicine (CAM)?

Correct Answer: C

Rationale: The correct answer is C: Feverfew. Feverfew is commonly used for its anti-inflammatory properties and may help reduce skin sensitivity to sunlight, which could be the cause of the patient's skin turning red and tender. St. John's wort is used for depression, Ginkgo biloba for memory, and Echinacea for immune support, none of which are directly related to the patient's symptom.

Question 3 of 9

When the job applicant is asked to identify weaknesses, one appropriate reply for the novice nurse might be:

Correct Answer: C

Rationale: The correct answer is C: "Delegating to peers." This response shows self-awareness and willingness to improve by acknowledging a common weakness for novice nurses - difficulty in delegating tasks to peers. It demonstrates a willingness to learn and grow in the role. A: "I have no weaknesses." - This answer lacks self-awareness and does not show a willingness to improve. It comes across as overconfident. B: "Are you trying to set me up?" - This response is defensive and unprofessional. It does not address the question directly. D: "Caring requires weakness." - This answer is vague and does not provide a specific weakness or show a proactive approach to self-improvement.

Question 4 of 9

A nurse is concerned about a trend in the hospital to regularly "float" nurses to different areas of the hospital based on staff shortage regardless of recent experience in caring for the population on the unit. When deciding to accept a staffing assignment in this situation, the nurse considers a "safe harbor." What is meant by "safe harbor"?

Correct Answer: D

Rationale: The correct answer is D because "safe harbor" refers to a legal provision that protects nurses when they feel unsafe accepting a staffing assignment due to lack of recent experience or competency. By invoking safe harbor, nurses can continue caring for patients while an investigation is conducted to ensure patient safety and protect the nurse's license. This process allows nurses to voice concerns without fear of reprisal. Option A is incorrect as it refers to a disaster response plan, unrelated to safe harbor. Option B is incorrect as it discusses patient care teams and infectious diseases, not safe harbor protections. Option C is incorrect because it addresses reporting violence, which is not directly related to safe harbor provisions for staffing assignments.

Question 5 of 9

When choosing to delegate, the nurse should delegate the task to the most qualified person or to the person he or she wishes to:

Correct Answer: A

Rationale: The correct answer is A: develop. When delegating tasks, it is important for the nurse to choose the most qualified person to ensure safe and effective care. By delegating tasks to someone who needs development, the nurse can provide opportunities for growth and skill enhancement. This benefits both the individual being delegated to and the overall team. Choices B, C, and D are incorrect because promoting, punishing, or rewarding someone based on task delegation can lead to bias, unfairness, or inappropriate incentives, which are not conducive to effective delegation practices.

Question 6 of 9

A nurse on the unit is heard saying, "I am not going to document that I used four catheters to start that IV; it doesn't matter anyway." What action can help the staff nurse understand the financial budget goals of the unit?

Correct Answer: C

Rationale: Rationale: Choice C is correct because asking the nurse to represent the unit on the budget planning committee will directly expose them to the financial budget goals. This involvement will provide insight into the importance of accurate documentation and resource utilization. It offers a practical understanding of how decisions impact the unit's financial health. Summary: A: Working in payroll does not directly connect the nurse to the unit's financial goals. B: Personal finance CEUs are not specific to the unit's budget goals. D: Monitoring supplies is important but does not provide a comprehensive understanding of the unit's financial budget goals.

Question 7 of 9

Care delivery using the team-based approach is used on a telemetry nursing unit. The team consists of one registered nurse (RN), two licensed practical nurses (LPNs), and one unlicensed assistive personnel (UAP). Staff have been charged to improve quality of care while ensuring cost containment. Which assignments would meet both criteria?

Correct Answer: B

Rationale: The correct answer is B because it aligns with improving quality of care and cost containment. LPNs are trained to perform sterile procedures like dressing changes and IV tubing changes, which can enhance patient outcomes. This assignment allows the RN to focus on tasks that require their specialized skills, promoting quality care. Furthermore, utilizing LPNs for these tasks is more cost-effective than having an RN perform them. Choices A, C, and D are incorrect: A: Having the RN administer all medications to all patients is not utilizing the team effectively. LPNs and UAPs can handle medication administration under appropriate supervision. C: While experienced UAPs can assist with attaching telemetry electrodes, this task does not fully utilize the skills of the LPNs and RN to improve care quality. D: Administering an enema is within the scope of an LPN's practice, and assigning this task to the RN is not the most efficient use of resources.

Question 8 of 9

A group of registered nurses with ADN degrees are concerned that the minimum educational standard for licensure as a registered nurse is being raised to the bachelor's (BSN) level. After contacting the American Nurses Association, they learn they will be "grandfathered" in. Under the "grandfather clause," nurses with associate degrees will:

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. The "grandfather clause" typically allows individuals to maintain current status or privileges despite changes in requirements. 2. The clause ensures that nurses with ADN degrees can continue using the title "registered nurse" without needing to upgrade to a BSN. 3. This aligns with the principle of honoring past qualifications while moving forward with new standards. 4. Choice A is incorrect as it introduces additional requirements beyond what the clause typically allows. 5. Choice C is incorrect as it imposes a strict time limit, which is not a common practice under grandfather clauses. 6. Choice D is incorrect as it suggests using a new title, which contradicts the purpose of grandfathering in existing qualifications.

Question 9 of 9

A patient observes the practitioner burning a dried herb on the needle during an acupuncture session and asks about this practice. The practitioner responds, "I am inciting the acupuncture points and this is referred to as:

Correct Answer: B

Rationale: The correct answer is B: moxibustion. Moxibustion is a traditional Chinese medicine technique that involves burning dried herbs on or near acupuncture points to stimulate them. This practice helps to improve the flow of Qi and promote healing. Doshas (choice A) and kapha (choice D) are terms from Ayurveda, not related to acupuncture. Yoga (choice C) is a separate practice that involves physical postures and breathing exercises, not burning herbs on acupuncture points.

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