ATI RN
Ethics and Issues in Contemporary Nursing Questions
Question 1 of 5
A nurse wants to apply open communication to obtain a thorough history and to determine cognitive function. Which question represents the use of open communication?
Correct Answer: C
Rationale: The correct answer is C because it encourages the patient to provide detailed information and express themselves freely. By asking the patient to "Tell me what day of the week today is," the nurse is prompting an open-ended response, allowing the patient to share their understanding. Choice A is closed-ended, requiring a simple yes/no answer. Choice B is slightly better as it prompts for information, but it is still closed-ended. Choice D is irrelevant to the question of determining cognitive function and history. In summary, C promotes open communication by encouraging the patient to elaborate, while the other choices limit the patient's response.
Question 2 of 5
A student nurse is concerned about delegation practices and wonders why hospitals employ unlicensed assistive personnel (UAP) and LPN/LVNs. The student nurse refers to the National Council of State Boards of Nursing and learns that the role of these personnel is to:
Correct Answer: B
Rationale: The correct answer is B: aid the RN by performing appropriately delegated care tasks. UAP and LPN/LVNs are crucial in supporting the RN by carrying out tasks within their scope of practice under the RN's supervision. This is essential to ensure efficient patient care delivery and allow the RN to focus on more complex nursing assessments and interventions. A: Supplementing the staffing pattern when an RN is not available is incorrect because UAP and LPN/LVNs work alongside RNs, not as substitutes for them. C: Replacing the RN in long-term care settings is incorrect as UAP and LPN/LVNs provide valuable assistance but do not replace the RN's role. D: Providing patient teaching to allow more direct care by the RN is incorrect as UAP and LPN/LVNs focus on task-based care rather than patient education, which is typically within the RN's scope of practice.
Question 3 of 5
An RN delegates to an experienced LPN/LVN the task of administering oral medications to a group of patients. The LPN/LVN accepts the assignment, and the RN knows that the LPN/LVN has had the training and has acquired the skills needed to complete the task. The RN then observes the LPN/LVN recording a patient's medication administration just before entering the patient's room. The priority intervention by the RN is to:
Correct Answer: B
Rationale: The correct answer is B: stop the LPN/LVN immediately and discuss the possible consequences of his actions in a nonjudgmental manner. This is the priority intervention because it addresses the immediate issue of potentially incorrect documentation and allows for clarity and understanding between the RN and LPN/LVN. It promotes open communication and a chance to correct any errors that may have occurred. Choice A is incorrect because checking the drug packages after the fact does not address the issue of potentially incorrect documentation and missed medications. Choice C is incorrect as it is an extreme response that does not promote a collaborative and educational approach to resolving the situation. Choice D is incorrect as calling the pharmacy for replacement medications is not necessary at this stage and does not address the immediate concern of potentially incorrect documentation.
Question 4 of 5
The RN instructs the LPN to "Give an enema to the patient in room 327 who is being discharged but is complaining of being constipated. Then be sure to document on the medication administration record when given." Which of the five rights was missing in this situation? The right of:
Correct Answer: A
Rationale: The correct answer is A: direction and communication. The RN failed to provide clear direction to the LPN regarding the specific type of enema to be administered and the amount. Furthermore, there was a lack of communication regarding the patient's current condition and the rationale for the enema. The other choices are incorrect because: B: task - The task of administering the enema was clearly communicated. C: person - The patient was identified by room number, so the person was specified. D: circumstances - While the circumstances of the patient's complaint were mentioned, the specific details related to the enema administration were lacking.
Question 5 of 5
Which statement made by an RN regarding delegation indicates the need for additional teaching? (select all that apply)
Correct Answer: A
Rationale: The correct answer is A. Delegating the assessment of vital signs during the first 5 minutes of a blood transfusion to UAPs is not appropriate. This is because a reaction can occur within the first few minutes of a blood transfusion, making it crucial for a registered nurse to assess the patient during this critical period. UAPs do not have the education or training to recognize and manage potential adverse reactions promptly. Choice B is incorrect because an LPN/LVN can indeed administer a PPD if there is no history of a positive result. Choice C is incorrect because LPN/LVNs should not administer medications that have a high potential for adverse effects, such as dopamine. Choice D is incorrect as transferring a patient who is being discharged home requires skilled nursing assessment and intervention, not just training in transferring techniques.