Which functions can be delegated only to another RN with appropriate experience and training? (select all that apply)

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Contemporary Ethical Issues in Nursing Questions

Question 1 of 9

Which functions can be delegated only to another RN with appropriate experience and training? (select all that apply)

Correct Answer: C

Rationale: The correct answer is C because nursing judgment related to withholding medication based on vital signs requires critical thinking, clinical knowledge, and experience. This decision-making process involves assessing the patient's condition, interpreting vital signs, and determining if medication should be given or withheld to ensure patient safety. This function cannot be delegated to someone without the appropriate training and expertise. A: Assessment of skin integrity on the third day of hospitalization can be delegated to other healthcare team members such as LPNs or nursing assistants, as long as they have been trained and deemed competent. B: Evaluation of patient teaching related to turn, cough, and deep breathing exercises can be delegated to other healthcare team members, as long as they have the appropriate training and supervision. D: The statement that RNs do not delegate to other RNs is incorrect. RNs can delegate certain tasks to other RNs based on their scope of practice and level of experience. It is not limited to LPNs or unlicensed assistive personnel.

Question 2 of 9

The mentor states, "Prevention was the focus of nursing when I graduated. We stressed preventive health measures such as smoking cessation education to reduce preventable diseases and prevention to reduce the spread of infectious disease such as AIDS." The mentor asks, "What do you think the challenges will be for nurses graduating now? The correct response would be: (select all that apply)

Correct Answer: A

Rationale: Step 1: The correct answer is A because nurses now face challenges in coordinating care for a more diverse aging population. This is due to the increasing complexity of health issues and values among this demographic. Step 2: As the aging population grows, nurses must be equipped to address the unique needs and preferences of diverse individuals, which requires a deep understanding of cultural, social, and health-related factors. Step 3: Nurses need to adapt their care delivery strategies to provide patient-centered care that considers the individual's values, beliefs, and preferences. This includes coordinating care across different healthcare settings and disciplines to ensure holistic and effective care. Summary: Choices B, C, and D are incorrect because they do not address the specific challenges faced by nurses graduating now, which primarily revolve around managing the complexities of caring for a diverse aging population with varying health values.

Question 3 of 9

The nurse manager meets with upper management to share strategic goals agreed upon by her staff for their individual nursing unit as the first step to begin budget negotiations. One strategic goal is that staff will have access to technology that will allow them to incorporate point-of-care devices for all RNs. The second goal is to improve RNs' ability to recognize critical indicators that a patient's health status is deteriorating through advanced health assessment skills. During the meeting the manager discusses the strategy options and selecting the one that works for the unit. Which type of budget development is used?

Correct Answer: C

Rationale: The correct answer is C: Participatory. In participatory budget development, input is gathered from various levels within the organization, such as staff and managers. In this scenario, the nurse manager met with her staff to establish strategic goals before budget negotiations, indicating a participatory approach. This allows for staff buy-in and ownership of the goals. A: Iterative budget development involves refining a budget through multiple rounds of review, which is not explicitly mentioned in the scenario. B: Top-down budget development is characterized by decisions made by upper management without input from lower levels, contradicting the scenario where staff provided input. D: Zero-based budgeting starts from scratch without considering previous budgets, which is not evident in the scenario where goals were established based on staff input. In summary, the participatory budget development is the appropriate choice in this scenario as it aligns with the collaborative approach taken by the nurse manager and her staff in setting strategic goals before budget negotiations.

Question 4 of 9

A state is devastated by a tornado killing many people, destroying communication systems, utility services, homes, and medical facilities. The state requests immediate assistance from the U.S. Congress and from surrounding states. The affected state should first contact the:

Correct Answer: A

Rationale: The correct answer is A: Emergency Management Assistance Compact (EMAC). 1. EMAC is a mutual aid agreement among states for disaster response. 2. It allows affected states to request and receive assistance from other states. 3. It facilitates coordination and deployment of resources quickly in emergencies. 4. IOM focuses on health research, Red Cross on humanitarian aid, and Strategic National Stockpile on medical supplies, but they do not provide the immediate multi-sectoral assistance needed in this scenario.

Question 5 of 9

A nursing unit is comparing team nursing to the partnership model and finds that:

Correct Answer: B

Rationale: The correct answer is B because the leadership abilities of the RN are crucial in both team nursing and the partnership model. In team nursing, the RN coordinates care provided by team members. In the partnership model, the RN collaborates with a partner to deliver care effectively. Choice A is incorrect because the presence of an RN is essential in both models to ensure the delivery of safe and high-quality care. Choice C is incorrect because the RN's role in teaching how to apply the nursing process is not specific to team nursing or the partnership model but is a general nursing responsibility. Choice D is incorrect because in team nursing, the RN is responsible for coordinating care for the patient, including working with the family or significant others, rather than solely caring for the patient while others work with the family.

Question 6 of 9

A nurse is caring for a patient who is to receive an antibiotic drug that causes severe skin damage when infiltrated. The order reads, "infuse over 1 hour by portacath." The nurse accesses the Personal Digital Assistant for software that lists the steps to access a portacath. The nurse is using:

Correct Answer: B

Rationale: The correct answer is B: point-of-care technology. Point-of-care technology refers to tools and devices that assist healthcare providers in delivering care at the patient's bedside. In this scenario, the nurse is accessing a software application on a Personal Digital Assistant to follow steps for accessing a portacath, which is a form of point-of-care technology. This technology enables quick and accurate access to necessary information, ensuring safe and efficient care delivery. Incorrect choices: A: Electronic health records (EHR) primarily store patient information and medical history but do not provide real-time guidance on procedures like accessing a portacath. C: Data management involves organizing and analyzing healthcare data but does not directly assist in patient care tasks like accessing a portacath. D: Telehealth involves remote healthcare services, which are not relevant to the nurse's immediate task of accessing a portacath.

Question 7 of 9

Although a hospital reversed all charges when a client was the victim of wrong site surgery, the court awarded the client $5 million. The client was able to return to work in 6 weeks and had no permanent damages. This monetary compensation is termed:

Correct Answer: B

Rationale: The correct answer is B: punitive damages. Punitive damages are awarded to punish the defendant for their wrongful actions. In this case, the hospital's negligence in performing wrong site surgery resulted in harm to the client, even though the hospital reversed the charges. The court awarded $5 million to punish the hospital for their negligence, as the client suffered emotional distress and the potential risk of harm. The other choices are incorrect because: A: res ipsa loquitur is a legal doctrine used to shift the burden of proof from the plaintiff to the defendant in cases where the negligence is obvious. C: vicarious liability holds an employer responsible for the actions of their employees, which is not directly applicable in this scenario. D: immunity refers to protection from legal liability, which is not relevant in a case where the court awarded monetary compensation.

Question 8 of 9

A nurse is assigned to a unit where 95% of all patients required total care. Most days the assistive personnel are able to complete their assignments and provide high-quality care. A patient returning from a procedure was somehow "skipped" when daily baths were performed and requests that her care now be provided. The nurse discovers the bed is rumpled and damp. The RN joins with some other staff to bathe the patient, change the bed, and help make the patient comfortable. These staff members are demonstrating:

Correct Answer: A

Rationale: The correct answer is A: altruism. Altruism is the selfless concern for the wellbeing of others, which is demonstrated by the staff members helping the patient in need without hesitation. In this scenario, the staff members are putting the patient's needs above their own, showing compassion and empathy. This aligns with the principle of altruism in nursing, where caregivers prioritize the welfare of their patients. Choices B, C, and D are incorrect: B: Veracity refers to truthfulness and honesty. While these are important traits in nursing, they are not the focus of the staff members' actions in this scenario. C: Autonomy is the right of individuals to make decisions about their own care. In this situation, the patient is not exercising autonomy, but rather relying on the staff for assistance. D: Whistle-blowing involves reporting unethical or illegal behavior within an organization. There is no indication of any wrongdoing that would require whistle-blowing in this scenario.

Question 9 of 9

A young child is having abdominal pain, and the doctor informs the parents that a computed tomography (CT or CAT) scan of the abdomen will be ordered. The doctor tells the child, "This CAT scan won't hurt you." The child is visibly upset because of a fear of cats. According to Mishel's uncertainty in illness theory, which stage of the framework is represented?

Correct Answer: A

Rationale: Step 1: The child is upset due to a fear of cats, leading to uncertainty about the situation. Step 2: Mishel's uncertainty in illness theory focuses on how individuals respond to uncertainty in health-related situations. Step 3: In this case, the child's fear of cats creates a misinterpretation of the term "CAT scan." Step 4: This misinterpretation falls under the Stimuli frame stage, where the individual perceives the situation based on external cues. Step 5: Other choices are incorrect as they do not directly address the initial misinterpretation caused by the fear of cats. In summary, choice A is correct because it aligns with Mishel's theory by highlighting the initial stimuli (fear of cats) causing uncertainty in the child's understanding of the situation. Choices B, C, and D are incorrect as they do not address the specific misinterpretation of the term "CAT scan" due to the fear of cats.

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