ATI Nur 175 Med Surg Exam | Nurselytic

Correct Answer: B

Rationale: Fidelity refers to the principle of keeping promises and being faithful to one's commitments. It involves loyalty and maintaining trust in the nurse-client relationship. While fidelity is important, it is not the most relevant principle in the context of respecting a client's decision to discontinue treatment. Autonomy is the ethical principle that recognizes an individual's right to make their own decisions and choices regarding their healthcare. Respecting a client's autonomy means acknowledging their right to refuse or discontinue treatment, even if the healthcare team disagrees with their decision. In this case, continued treatment against the client's wishes would violate their autonomy. Justice refers to the principle of fairness and equality in the distribution of resources and care. It involves ensuring that all clients receive equitable treatment. While justice is a key ethical principle, it is not the primary issue when considering the client's wish to discontinue ventilator support. Veracity refers to the principle of truthfulness and honesty in communication with clients. It involves providing accurate and complete information to enable clients to make informed decisions. While veracity is essential, it does not directly address the issue of respecting the client's decision to discontinue treatment.

Correct Answer: C

Rationale: While giving a report to the oncoming shift at the client's bedside might potentially expose confidential information, it is generally an accepted practice in many healthcare settings as long as privacy is maintained and the patient consents. Shredding a client's printed laboratory results is actually a good practice to ensure that confidential information is disposed of securely, preventing unauthorized access. Posting any information about a client on social media, even if it is positive, is a direct breach of client confidentiality. This action exposes the client's personal health information to a wide audience, violating privacy regulations such as HIPAA. Logging off the computer before leaving the workstation is a good practice to protect client information from unauthorized access and does not represent a breach of confidentiality.

Correct Answer: B

Rationale: Providing a centralized area for stocking the needed supplies is important for logistical reasons, ensuring that all necessary materials are readily available. However, this is not the primary scientific rationale for designating a specific decontamination area. The primary focus is on preventing contamination and ensuring safety. Preventing secondary contamination to health-care providers is the most crucial reason for designating a specific area for decontamination. This measure is vital to avoid spreading hazardous substances to others and ensuring the safety and effectiveness of the decontamination process. By containing the contamination in a controlled area, health-care providers can minimize the risk of exposure and cross-contamination. Designating an area where bioterrorism clients can receive care is important, but it is not the primary rationale for having a specific decontamination area. While care and treatment are critical, the main goal of the decontamination area is to remove contaminants and protect health-care providers and other patients from exposure. Providing showers and privacy to the client in the decontamination area is beneficial for the comfort and dignity of the client. However, this is not the main scientific rationale for having a designated decontamination area. The primary reason is to control and contain contamination and prevent it from spreading.

Correct Answer: D

Rationale: The red category in START triage is reserved for clients who need immediate intervention to survive. This includes those with life-threatening injuries such as severe bleeding or airway obstruction. In this scenario, the 10-year-old client is awake, alert, and ambulatory, indicating that their condition is not immediately life-threatening.
Therefore, the red category is not applicable. The green category is used for clients who are able to walk and have minor injuries. While the 10-year-old client is ambulatory, the presence of a headache and neck pain suggests that their injuries might be more severe than minor. The green category would not be appropriate because their symptoms indicate a need for further evaluation and monitoring. The black category is assigned to clients who are deceased or have injuries so severe that survival is unlikely even with immediate medical intervention. The 10-year-old client is awake, alert, and able to walk, which clearly does not align with the criteria for the black category.
Therefore, this category is not suitable for the client's condition. The yellow category in START triage is for clients who require medical attention but their injuries are not immediately life-threatening. Given that the 10-year-old client is reporting a headache and neck pain, there is a potential risk of underlying injury that warrants attention but does not require immediate intervention. Thus, the yellow category is the most appropriate acuity level for this client.

Correct Answer: D

Rationale: A client with lymphoma receiving inpatient chemotherapy is likely to require close monitoring and ongoing treatment due to the potential complications associated with their condition and treatment. Discharging this client could put them at significant risk. A client with heart failure with crackles bilaterally on 4 liters of oxygen needs continuous medical supervision and care to manage their heart condition and oxygen levels. Discharging this client could exacerbate their heart failure and lead to serious health complications. A client who is post-appendectomy with a paralytic ileus is at risk of complications such as bowel obstruction and infection. They need to be closely monitored in the hospital until their condition stabilizes and they begin to recover from surgery. A client with a nondisplaced tibia fracture that has been immobilized is generally stable and can be safely discharged with appropriate instructions for home care. This client does not require intensive monitoring and can continue their recovery at home.