ATI RN
Ethics and Issues in Contemporary Nursing PDF Questions
Question 1 of 5
Which task is most likely to be considered in a state's practice act as appropriate to delegate to a LPN/LVN if the patient's condition is stable and competence in the task has been established?
Correct Answer: D
Rationale: The correct answer is D. Teaching a patient how to instill eye drops for glaucoma is a task that can be appropriately delegated to an LPN/LVN when the patient is stable and competence has been established. Here's the rationale: 1. Teaching is within the scope of practice for LPN/LVNs as it involves providing education and instructions to patients. 2. Administering medications IV (option B) requires a higher level of assessment and monitoring skills, making it inappropriate for delegation to an LPN/LVN. 3. Developing a plan of care (option C) involves critical thinking and decision-making skills beyond the scope of an LPN/LVN. 4. Administering an enema (option A) may involve assessing the patient's condition and response, which is beyond the typical scope of an LPN/LVN.
Question 2 of 5
During orientation, an RN learns that LPN/LVNs in the facility receive additional training to perform some tasks such as hanging continuously infusing intravenous fluids that have no additives. It is important for the RN to understand that:
Correct Answer: B
Rationale: Rationale for Correct Answer (B - LPN/LVNs are licensed, and accountability for their own practice rests with each LPN/LVN): 1. LPN/LVNs are licensed professionals, accountable for their own scope of practice as outlined by the state nursing board. 2. Accountability ensures that LPN/LVNs are responsible for their actions and decisions in providing patient care. 3. LPN/LVNs must adhere to the state's nursing practice act and regulations, ensuring safe and competent care delivery. Summary of Incorrect Choices: A: The health care facility cannot override the state practice act as licensure requirements are set by the state nursing board. C: UAPs, although important in the care team, do not have the same level of accountability as licensed nurses. D: The nurse practice act and state regulations related to delegation are essential in guiding delegation practices, but they do not necessarily override organization policies.
Question 3 of 5
A registered nurse (RN) is assigned as charge nurse for the first time. She knows to consult the state board of nursing to determine scope of practice for licensed practical nurses (LPN) and unlicensed assistive personnel (UAP). She also realizes there are common policies which exist in most state practice acts that include:
Correct Answer: D
Rationale: The correct answer is D because when delegating tasks, the RN must first assess the patient to determine their needs and condition. This assessment is crucial in deciding which tasks can be safely delegated to the LPN or UAP. By assessing the patient, the RN can ensure that the delegated tasks are appropriate, match the competency of the delegatee, and are within the scope of practice for each individual. This step is essential to maintain patient safety and quality of care. Choice A is incorrect because while the RN is accountable for the decision to delegate, both accountability and responsibility rest with the RN, not just the delegatee. Choice B is incorrect because tasks should only be delegated within the scope of practice of the delegatee, not based on the delegatee's personal certainty of competence. Choice C is incorrect as LPNs have a distinct scope of practice that is separate from professional nursing, and they do not practice professional nursing.
Question 4 of 5
Accrediting agencies such as The Joint Commission address staffing by:
Correct Answer: D
Rationale: The correct answer is D because accrediting agencies like The Joint Commission focus on ensuring patients receive satisfactory care through evidence-based practices. They evaluate the quality of care provided rather than specific staffing levels or ratios. Imposing maximum staffing levels (A) can be restrictive and may not account for varying patient needs. Requiring a specific staff mix (B) may not always be feasible or reflective of best practices. Stipulating nurse-patient ratios (C) can be important but may not address the overall quality of care provided to patients. In summary, option D is correct as accrediting agencies prioritize evidence of satisfactory care delivery over rigid staffing requirements.
Question 5 of 5
A patient is admitted with coronary artery disease and is scheduled for coronary artery bypass grafting (CABG). According to the clinical pathway the patient should be extubated and discharged from critical care the day after surgery. During surgery the patient's oxygen saturation decreased drastically as a result of chronic tobacco abuse. Subsequently, the patient remained on the ventilator an additional 2 days postoperatively. According to the clinical practice guideline for CABG, this situation represents a:
Correct Answer: B
Rationale: The correct answer is B: variance. In this scenario, the patient's extended time on the ventilator deviates from the expected clinical pathway of extubation and discharge the day after surgery. Variances are deviations from established protocols or guidelines. This situation highlights a deviation from the standard practice and requires further evaluation to understand the reasons for the delay in extubation. The other choices are incorrect because: A: Patient outcome refers to the result of care received by the patient, not the deviation from the expected process. C: Goal represents the desired outcome or target to achieve, not the deviation from the pathway. D: Standard is the established protocol or guideline to follow, not the deviation from it.