A nurse using the principle-based approach to client care seeks to avoid causing harm to clients in all situations. What is this principle known as?

Correct Answer: C

Rationale: In the context of nursing, the principle of nonmaleficence refers to the ethical obligation to avoid causing harm to clients. This principle is a fundamental component of nursing ethics and guides nurses in their practice to prioritize the well-being and safety of their clients above all else. By adhering to the principle of nonmaleficence, nurses aim to prevent harm and minimize risks to their clients during the provision of care. Option A, fidelity, refers to the ethical principle of being faithful and keeping promises or commitments made to clients. While important in nursing practice, fidelity is not specifically about avoiding harm. Option B, autonomy, pertains to respecting a client's right to make their own decisions about their care. Autonomy is about promoting a client's independence and self-determination, rather than solely focusing on avoiding harm. Option D, justice, involves the fair and equal distribution of resources and treatment among clients. While justice is crucial in nursing to ensure fairness, it does not directly correlate with the principle of avoiding harm. In an educational context, understanding the principle of nonmaleficence is essential for nursing students as it forms the basis of ethical nursing practice. By recognizing the significance of this principle, students can develop a strong ethical foundation that prioritizes the safety and well-being of their clients. This knowledge guides nurses in making informed and ethical decisions to provide high-quality care while minimizing the risk of harm to clients.

Correct Answer: B

Rationale: In an Introduction to Nursing exam, assessing a patient's cerebral function is crucial for identifying potential neurological issues. The correct answer, "B) Do you have difficulty remembering things?" is key because memory is closely linked to cerebral function. Memory loss or difficulty can indicate cognitive impairment, which may be indicative of neurological conditions. Option A, asking about numbness and tingling, is more related to peripheral nerve function rather than cerebral function. Option C, inquiring about balance problems, is more associated with cerebellar function and not solely cerebral. Option D, asking about taste issues, is linked to cranial nerve function, specifically the gustatory nerve, and does not directly assess cerebral function. Educationally, understanding the specific nature of questions aimed at assessing different aspects of neurological function is essential for nurses to provide comprehensive care. By focusing on the correct indicators, nurses can better identify and address potential neurological issues in patients.

Correct Answer: B

Rationale: In nursing practice, percussion is a technique used to assess underlying tissues by producing sounds. In the abdomen, the sound that should be heard over most of the area is tympany. Tympanic sounds are high-pitched, drum-like sounds that are produced over air-filled structures. In the abdomen, this sound is typically heard over the stomach and intestines due to the presence of gas. The other options are incorrect for the following reasons: A) Dullness: Dull sounds are heard over solid organs or masses, indicating abnormal findings such as organ enlargement or tumors. C) Grating: Grating sounds suggest friction between inflamed surfaces and are not expected during abdominal percussion. D) Gurgling: Gurgling sounds, also known as bowel sounds, are heard through auscultation and indicate normal gastrointestinal motility but are not elicited during percussion. Educationally, understanding the different sounds produced during percussion is crucial for nursing students as it helps in the assessment of various body systems. Recognizing normal and abnormal sounds aids in diagnosing underlying conditions and implementing appropriate interventions. Mastery of percussion techniques enhances a nurse's ability to conduct thorough physical assessments, leading to improved patient care outcomes.

Correct Answer: B

Rationale: The correct answer is B) purpose, direction, leadership. During the end of the Middle Ages, nursing was primarily focused on the purpose of providing care to the sick, establishing a direction for healthcare practices, and demonstrating leadership in the caregiving role. This is reflective of the historical context where nursing was often carried out by religious orders and laypeople under the direction of the church. Option A) continuity, caring, critical thinking, while important aspects of nursing practice, may not have been the primary focus during the end of the Middle Ages. Nursing care was more centered around basic needs and spiritual comfort rather than continuity and critical thinking. Option C) assessment, interventions, outcomes, and Option D) advocacy, research, education, are all essential components of modern nursing practice but they were not the defining characteristics of nursing during the end of the Middle Ages. Assessment and interventions were limited, outcomes were not measured in the same way as today, and advocacy, research, and formal education in nursing were not prominent during this historical period. In an educational context, understanding the historical evolution of nursing helps students appreciate how the profession has developed over time and how societal factors influence the focus and priorities of nursing practice. It also underscores the importance of leadership and purpose in shaping the nursing role within different historical contexts.

Correct Answer: D

Rationale: The correct answer is D) Referring a teen who admits having suicidal thoughts to a mental healthcare specialist. This action best exemplifies the collaborator role of a nurse because it involves recognizing the need for specialized care beyond the nurse's scope of practice and engaging other healthcare professionals to provide comprehensive support for the patient. Option A, discussing legal aspects of adoption, is not primarily a collaborative role but rather falls more under the educator role as it focuses on providing information. Option B, searching the internet for child care information, is not the best use of nursing skills and does not involve collaboration with other healthcare professionals. Option C, conducting a patient interview and documenting information, is a fundamental nursing responsibility but does not specifically demonstrate collaboration beyond the nursing role. In an educational context, understanding the different roles of a nurse, including collaborator, is crucial for providing effective and holistic care to patients. Nurses must know when to involve other healthcare team members to address the diverse needs of individual patients, especially in complex situations like suicidal ideation. This question highlights the importance of interprofessional collaboration in nursing practice.