The best explanation of what Title VI of the Civil Rights Act mandates is the freedom to:
A. Pick any physician and insurance company despite one's
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B. Receive free medical benefits as needed within the county of residence
C. Have equal access to all health care regardless of race and religion
D. Have basic care with a sliding scale payment plan from all health care facilities
Answer: C. Have equal access to all health care regardless of race and religion
Which statement would best explain the role of the nurse when planning care for a culturally diverse population? The nurse will plan care to:
A. Include care that is culturally congruent with the staff from predetermined criteria
B. Focus only on the needs of the client, ignoring the nurse's beliefs and practices
C. Blend the values of the nurse that are for the good of the client and minimize the client's individual values and beliefs during care
D. Provide care while aware of one's own bias, focusing on the client's individual needs rather than the staff's practices
Answer: D. Provide care while aware of one's own bias, focusing on the client's individual needs rather than the staff's practices
Without understanding one's own beliefs and values, a bias or preconceived belief by the nurse could create an unexpected conflict or an area of neglect in the plan of care for a client (who might be expecting something totally different from the care). During assessment values, beliefs, practices should be identified by the nurse and used as a guide to identify the choices by the nurse to meet specific needs/outcomes of that client. Therefore identification of values, beliefs, and practices allows for planning meaningful and beneficial care specific for this client.
Which factor is least significant during assessment when gathering information about cultural practices?
A. Language, timing
B. Touch, eye contact
C. Biocultural needs
D. Pain perception, management expectations
Answer: C. Biocultural needs
Cultural practices do not influence biocultural needs because they are inborn risks that are related to a biological need and not a learned cultural belief or practice.
Transcultural nursing implies:
A. Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate
B. Working in another culture to practice nursing within their limitations
C. Combining all cultural beliefs into a practice that is a non-threatening approach to minimize cultural barriers for all clients' equality of care
D. Ignoring all cultural differences to provide the best generalized care to all clients
Answer: A. Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate
Transcultural care means that by understanding and learning about specific cultural practices the nurse can integrate these practices into the plan of care for a specific individual client who has the same beliefs or practices to meet the client's needs in a holistic manner of care.
What should the nurse do when planning nursing care for a client with a different cultural background? The nurse should:
A. Allow the family to provide care during the hospital stay so no rituals or customs are broken
B. Identify how these cultural variables affect the health problem
C. Speak slowly and show pictures to make sure the client always understands
D. Explain how the client must adapt to hospital routines to be effectively cared for while in the hospital
Answer: B. Identify how these cultural variables affect the health problem
Without assessment and identification of the cultural needs, the nurse cannot begin to understand how these might influence the health problem or health care management.
Which activity would not be expected by the nurse to meet the cultural needs of the client?
A. Promote and support attitudes, behaviors, knowledge, and skills to respectfully meet client's cultural needs despite the nurse's own beliefs and practices
B. Ensure that the interpreter understands not only the language of the client but feelings and attitudes behind cultural practices to make sure an ethical balance can be achieved
C. Develop structure and process for meeting cultural needs on a regular basis and means to avoid overlooking these needs with clients
D. Expect the family to keep an interpreter present at all times to assist in meeting the communication needs all day and night while hospitalized
Answer: D. Expect the family to keep an interpreter present at all times to assist in meeting the communication needs all day and night while hospitalized
It is not the family's responsibility to assist in the communication process. Many families will leave someone to help at times, but it is the hospital's legal obligation to find an interpreter for continued understanding by the client to make sure the client is fully informed and comprehends in his or her primary language.
Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the:
A. American Nurses Association's (ANA's) Code of Ethics
B. Nurse Practice Act (NPA) written by state legislation
C. Standards of care from experts in the practice field
D. Good Samaritan laws for civil guidelines
Answer: A. American Nurses Association's (ANA's) Code of Ethics
This set of ethical principles provides the professional guidelines established by the ANA to maintain the highest standards for ideal conduct in practice. As a profession, the ANA wanted to establish rules and then incorporate guidelines for accountability and responsibility of each nurse within the practice setting.
A bioethical issue should be described as:
A. The physician's making all decisions of client management without getting input from the client
B. A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy.
C. The withholding of food and treatment at the request of the client in a written advance directive given before a client acquired permanent brain damage from an accident.
D. After the client gives permission, the physician's disclosing all information to the family for their support in the management of the client.
Answer: B. A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy.
The ethical issue was the inequality of treatment based strictly upon racial differences. Secondly, the drug was deliberately withheld even after results showed that the drug was working to cure the disease process in the white men for many years. So after many years, the black men were still not treated despite the outcome of the research process that showed the drug to be effective in controlling the disease early in the beginning of the research project. Therefore harm was done. Nonmaleficence, veracity, and justice were not followed.
When the nurse described the client as "that nasty old man in 354," the nurse is exhibiting which ethical dilemma?
A. Gender bias and ageism
B. HIPAA violation
C. Beneficence
D. Code of ethics violation
Answer: A. Gender bias and ageism
Stereotyping an "old man" as "nasty"is a gender bias and an ageism issue. The nurse is verbalizing a negative descriptor about the client.
The distribution of nurses to areas of "most need" in the time of a nursing shortage is an example of:
A. Utilitarianism theory
B. Deontological theory
C. Justice
D. Beneficence
Answer: C. Justice
Justice is defined as the fairness of distribution of resources. However, guidelines for a hierarchy of needs have been established, such as with organ transplantation. Nurses are moved to areas of greatest need when shortages occur on the floors. No floor is left without staff, and another floor that had five staff will give up two to go help the floor that had no staff.
Nurses are bound by a variety of laws. Which description of a type of law is correct?
A. Statutory law is created by elected legislature, such as the state legislature that defines the Nurse Practice Act (NPA).
B. Regulatory law includes prevention of harm for the public and punishment for those laws that are broken.
C. Common law protects the rights of the individual within society for fair and equal treatment.
D. Criminal law creates boards that pass rules and regulations to control society.
Answer: A. Statutory law is created by elected legislature, such as the state legislature that defines the Nurse Practice Act (NPA).
Statutory law is created by legislature. It creates statues such as the NPA, which defines the role of the nurse and expectations of the performance of one's duties and explains what is contraindicated as guidelines for breach of those regulations.
Besides the Joint Commission on Accreditation of Healthcare Organizations (JACHO), which governing agency regulates hospitals to allow continued safe services to be provided, funding to be received from the government and penalties if guidelines are not followed?
A. Board of Nursing Examiners (BNE)
B. Nurse Practice Act (NPA)
C. American Nurses Association (ANA)
D. Americans With Disabilities Act (ADA)
Answer: D. Americans With Disabilities Act (ADA)
If the hospital fails to follow ADA guidelines for meeting special needs, the facility loses funding and status for receiving low-income loans or reimbursement of expenses. ADA protects the civil rights of disabled people. It applies to both the hospital clients and hospital staff. Privacy issues for persons who are positive for human immunodeficiency virus (HIV) have been one issue in relationship to getting information when hospital staff have been exposed to unclean sticks. The ADA allows the infected client the right to choose whether or not to disclose that information.
When a client is confused, left alone with the side rails down, and the bed in a high position, the client falls and breaks a hip. What law has been broken?
A. Assault
B. Battery
C. Negligence
D. Civil tort
Answer: C. Negligence
Knowing what to do to prevent injury is a part of the standards of care for nurses to follow. Safety guidelines dictate raising the side rails, staying with the client, lowering the bed, and observing the client until the environment is safe. As a nurse, these activities are known as basic safety measures that prevent injuries, and to not perform them is not acting in a safe manner. Negligence is conduct that falls below the standard of care that protects others against unreasonable risk of harm.
When signing a form as a witness, your signature shows that the client:
A. Is fully informed and is aware of all consequences.
B. Was awake and fully alert and not medicated with narcotics.
C. Was free to sign without pressure
D. Has signed that form and the witness saw it being done
Answer: D. Has signed that form and the witness saw it being done
Your signature as a witness only states that the person signing the form was the person who was listed in the procedure.
Which criterion is needed for someone to give consent to a procedure?
A. An appointed guardianship
B. Unemancipated minor
C. Minimum of 21 years or older
D. An advocate for a child
Answer: A. An appointed guardianship
A guardian has been appointed by a court and has full legal rights to choose management of care.
Which statement is correct?
A. Consent for medical treatment can be given by a minor with a sexually transmitted disease (STD).
B. A second trimester abortion can be given without state involvement.
C. Student nurses cannot be sued for malpractice while in a nursing clinical class.
D. Nurses who get sick and leave during a shift are not abandoning clients if they call their supervisor and leave a message about their emergency illness.
Answer: A. Consent for medical treatment can be given by a minor with a sexually transmitted disease (STD).
Anyone, at any age, can be treated without parental permission for an STD infection. The client is "advised" to contact sexual partners but is not "required" to give names. Permission from parents is not needed, based upon current privacy laws.
Most litigation in the hospital comes from the:
A. Nurse abandoning the clients when going to lunch
B. Nurse following an order that is incomplete or incorrect
C. Nurse documenting blame on the physician when a mistake is made
D. Supervisor watching a new employee check his or her skills level
Answer: B. Nurse following an order that is incomplete or incorrect
The nurse is responsible for clarifying all orders that are illegible, unreasonable, unsafe, or incorrect. The failure of the nurse to question the physician about an order creates an area of liability on the nurse's part because this is perceived as a medical action and not the role of the nurse to write orders. Some RNs do have prescriptive privileges based upon advanced degrees and certification. Therefore the nurse who cannot correct the order must document that the physician was called and clarification or a new order was given to correct the unclear or illegible one that was currently on the chart. Phone calls, follow-up, and lack of follow-up by the physician should also be documented if there is a problem with getting the information in a timely manner. The nurse must show the sequence of events of a situation in a clear manner if there is any conflict or question about any orders or procedures that were not appropriate. Assessments and documentation of the client's status should also be included if there is a potential risk for harm present. Contact of the staff's chain of command should also be specifically stated for the proof of the responsibilities being followed according to hospital policy.
The nurse places an aquathermia pad on a client with a muscle sprain. The nurse informs the client the pad should be removed in 30 minutes. Why will the nurse return in 30 minutes to remove the pad?
A. Reflex vasoconstriction occurs.
B. Reflex vasodilation occurs.
C. Systemic response occurs.
D. Local response occurs.
Answer: A. Reflex vasoconstriction occurs.
If heat is applied for 1 hour or more, blood flow is reduced by reflex vasoconstriction. Vasoconstriction is the opposite of the desired effect of heat application
A client has recently been told he has terminal cancer. As the nurse enters the room, he yells, "My eggs are cold, and I'm tired of having my sleep interrupted by noisy nurses!" The nurse may interpret the client's behavior as:
A. An expression of the anger stage of dying
B. An expression of disenfranchised grief
C. The result of maturational loss
D. The result of previous losses
Answer: A. An expression of the anger stage of dying
In the anger stage of Kubler-Ross's stages of dying, the individual resists the loss and may strike out at everyone and everything, in this case, the nurse.
When helping a person through grief work, the nurse knows:
A. Coping mechanisms that were effective in the past are often disregarded in response to the pain of a loss
B. A person's perception of a loss has little to do with the grieving process.
C. The sequencing of stages of grief may occur in order, they may be skipped, or they may recur.
D. Most clients want to be left alone.
Answer: C. The sequencing of stages of grief may occur in order, they may be skipped, or they may recur.
Grief is manifested in a variety of ways that are unique to an individual and based on personal experiences, cultural expectations, and spiritual beliefs. The sequencing of stages or behaviors of grief may occur in order, they may be skipped, or they may recur. The amount of time to resolve grief also varies among individuals.
A client is hospitalized in the end stage of terminal cancer. His family members are sitting at his bedside. What can the nurse do to best aid the family at this time?
A. Limit the time visitors may stay so they do not become overwhelmed by the situation.
B. Avoid telling family members about the client's actual condition so they will not lose hope.
C. Discourage spiritual practices because this will have little connection to the client at this time.
D. Find simple and appropriate care activities for the family to perform
Answer: D. Find simple and appropriate care activities for the family to perform.
It is helpful for the nurse to find simple care activities for the family to perform, such as feeding the client, washing the client's face, combing hair, and filling out the client's menu. This helps the family demonstrate their caring for the client and enables the client to feel their closeness and concern. a. Older adults often become particularly lonely at night and may feel more secure if a family member stays at the bedside during the night. The nurse should allow visitors to remain with dying clients at any time if the client wants them. It is up to the family to determine if they are feeling overwhelmed, not the nurse. [Show Less]