A nurse is concerned about the practice of routinely ordering a battery of laboratory tests for patients who are admitted to the hospital from a long-term care facility. An appropriate source in handling this ethical dilemma would be which of the following?

Correct Answer: D

Rationale: The correct answer is D: the institutional ethics committee. The ethics committee is the appropriate source for handling ethical dilemmas as they are trained to provide guidance on complex ethical issues in healthcare settings. They can review the situation, consider various perspectives, and provide recommendations based on ethical principles and standards. In this case, the nurse can consult the ethics committee to evaluate the practice of ordering unnecessary tests and determine the most ethical course of action. Summary of other choices: A: the patient's family - While the family may have valuable input, they may not have the expertise to resolve ethical dilemmas in healthcare settings. B: the admitting physician - The physician may have limited perspective and may not be impartial in making decisions regarding routine testing. C: the nurse in charge of the unit - The nurse may have insights but may not have the authority or expertise to handle complex ethical dilemmas effectively.

Correct Answer: D

Rationale: The correct answer is D: evidence that learning has occurred. This is the most critical element as it demonstrates the effectiveness of the teaching. Evidence of learning ensures that the patient has understood the information and can apply it. Without this evidence, it is difficult to assess the impact of the teaching. A summary of the teaching plan (choice A) is important for organization but does not directly show if learning has occurred. The implementation of the teaching plan (choice B) is necessary but does not guarantee learning. Patient need for learning (choice C) is important to consider but does not assess if learning has actually taken place.

Correct Answer: A

Rationale: The correct answer is A: Exercise. George used exercise as a stress management technique. Swimming during his lunch hour helped him reduce his anxiety and jitteriness. Exercise is known to release endorphins, which are chemicals in the brain that act as natural painkillers and mood elevators. It also helps in reducing stress hormones like cortisol. By engaging in physical activity, George was able to alleviate his feelings of anxiety. Summary: - Choice B: Deep breathing focuses on controlling breathing patterns to reduce stress, but it was not mentioned in the scenario that George used this technique. - Choice C: Guided imagery involves visualizing calming and peaceful images to reduce stress, which was not mentioned in George's case. - Choice D: Progressive muscle relaxation involves tensing and relaxing different muscle groups to reduce stress, but George did not use this technique as mentioned in the scenario.

Correct Answer: B

Rationale: The correct answer is B: The hospital ID Band is left in place. This guideline is crucial for proper identification of the deceased individual. Removing the ID band could lead to confusion or misidentification. Vital signs assessment (A) is unnecessary post-mortem. Checking for a signed death certificate (C) is not a nursing responsibility. Following policies and procedures (D) is important but not specific to preparing a body for the morgue.

Correct Answer: D

Rationale: The correct answer is D. Holding her hand, sitting with her, and listening best depicts the "Caring" aspect of SENC (Systematic Empathetic Nursing Communication). This action shows empathy, presence, and active listening, which are crucial in supporting the patient emotionally. It allows the patient to express her feelings and concerns freely. A: Calling the parents back may provide support, but it doesn't directly address the patient's emotional needs. B: Suggesting the Chaplain can help is important, but in this scenario, direct emotional support from the nurse is essential. C: Crying with the client may not be appropriate as it can escalate the patient's emotions and blur professional boundaries.