Nursing Elites

1. A client is refusing to stay in the hospital because he does not agree with his healthcare treatment plan. The nurse stops the client from leaving due to concern for his health. Which of these legal charges could the nurse face?

• A. False imprisonment, as the nurse is not allowing the client to leave as he has decided to.
• B. Malpractice, as the nurse is intentionally keeping the patient from making his own decisions, thus violating that nursing duty.
• C. Invasion of privacy, as the nurse is getting involved in the patient's private decisions regarding healthcare.
• D. Negligence, as the nurse ignored the client's right to choose regarding his healthcare.

Correct answer: A

Rationale: Refusing to let a client leave against medical advice (AMA) is a form of false imprisonment. In this scenario, the nurse is restricting the client's freedom of movement by preventing him from leaving the hospital, even though he has expressed his wish to leave. False imprisonment is a legal charge the nurse could face in this situation. The other options are incorrect: - Malpractice refers to professional negligence or failure to provide adequate care, not allowing a patient to make their own decisions. - Invasion of privacy involves disclosing confidential information without consent, not preventing a patient from leaving. - Negligence is the failure to take reasonable care, but it does not specifically address the act of restricting a patient from leaving against their wishes.

2. Which of the following symptoms is not indicative of autonomic dysreflexia in the client with a spinal cord injury?

• A. sudden onset of headache
• B. flushed face
• C. hypotension
• D. nasal congestion

Correct answer: C

Rationale: Autonomic dysreflexia is characterized by a sudden onset of symptoms due to an overactive autonomic nervous system. Hypotension is not indicative of autonomic dysreflexia; instead, hypertension is a hallmark sign. Therefore, hypotension is the correct answer. Flushed face, sudden onset of headache, and nasal congestion are classic symptoms of autonomic dysreflexia caused by a noxious stimulus below the level of the spinal cord injury. These symptoms result from the body's attempt to regulate blood pressure when the normal feedback loop is interrupted.

3. After securing the client's safety from a faulty electric bed, what should the nurse do next?

• A. Discuss the matter with the client's significant others.
• B. Document the incident in the client's record in detail.
• C. Notify the physician.
• D. Prepare an incident report.

Correct answer: D

Rationale: After ensuring the client's safety from the faulty electric bed, the nurse should prioritize preparing an incident report. This report documents the details of what happened and is crucial for quality improvement and risk management. Choice A, discussing the matter with the client's significant others, may be important in some cases but is not the immediate priority after a safety incident. Choice B, documenting the incident in the client's record, is necessary but should be preceded by preparing an incident report. Choice C, notifying the physician, is important but not as urgent as preparing the incident report to ensure timely reporting and investigation of the safety issue.

4.

• A. delta sleep
• B. slow brain waves
• C. pneumonia
• D. circadian rhythm

Correct answer: D

Rationale:

5. A client admitted to the hospital has a do-not-resuscitate (DNR) order in his medical record. The nurse understands which information about DNR orders?

• A. The only individuals who may change the DNR order are healthcare providers
• B. The DNR order can be changed if the client's condition warrants it
• C. The DNR order does not remain fixed for the duration of the client's hospitalization
• D. The DNR order requires frequent review as specified by state or agency policy

Correct answer: D

Rationale: The correct answer is that the DNR order requires frequent review as specified by state or agency policy. If the client's condition changes, the DNR order may need to be changed. For this reason, DNR orders require frequent review as specified by state or agency policy. A DNR order may be changed at any time and does not remain in effect for the duration of the client's hospitalization. The client's request regarding DNR status is the priority. Choice A is incorrect because healthcare providers, not just immediate family members, may change the DNR order based on the client's condition. Choice B is incorrect as DNR orders can be changed if the client's condition warrants it, not remaining unchanged. Choice C is incorrect as DNR orders are not fixed for the duration of hospitalization, they can be modified based on the client's needs.

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