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1. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?
- A. Ask the client to consider a direct donation
- B. Withhold the blood transfusion
- C. Ask the client to consider a direct donation
- D. Request a consultation with the ethics committee
Correct answer: A
Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.
2. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?
- A. Carefully assess and document client status.
- B. Ensure all patient information is logged out and the nurse has signed out of the computer before leaving the computer station.
- C. Keep careful notes while providing care to ensure accurate documentation later in the day.
- D. Discuss safety needs with clients.
Correct answer: A
Rationale: The correct answer is A: Carefully assess and document client status. By carefully assessing and documenting the client's status, healthcare providers can ensure they have a clear understanding of the client's condition, needs, and any potential risks. This helps in providing appropriate care and avoiding situations that may lead to charges of negligence or false imprisonment. Choice B is incorrect because logging out of computer systems is more related to data security and confidentiality rather than preventing negligence or false imprisonment. Choice C is not directly related to avoiding charges of negligence and false imprisonment but rather ensuring accurate documentation. Choice D, while important for overall client safety, does not specifically address the issue of avoiding charges of negligence and false imprisonment for confused clients.
3. A technique used to eliminate negative behavior by ignoring the behavior is known as __________.
- A. Punishment
- B. Extinction
- C. Shaping
- D. Equity
Correct answer: B
Rationale: The correct answer is B, 'Extinction.' Extinction is a behavioral psychology technique where undesirable behavior is ignored, leading to its eventual decrease or elimination. This process involves withholding reinforcement that was previously maintaining the behavior. Choice A, 'Punishment,' involves applying negative consequences to reduce unwanted behavior, which is different from extinction. Choice C, 'Shaping,' is a method of gradually molding or reinforcing behaviors to reach a desired behavior, not ignoring negative behavior. Choice D, 'Equity,' refers to fairness and equal treatment, which is unrelated to eliminating negative behavior through ignoring it.
4. What is the primary purpose of a patient-centered medical home (PCMH)?
- A. To coordinate all aspects of patient care
- B. To reduce healthcare costs
- C. To implement the latest clinical guidelines
- D. To provide financial incentives for providers
Correct answer: A
Rationale: The correct answer is A: 'To coordinate all aspects of patient care.' A patient-centered medical home (PCMH) aims to provide comprehensive and continuous care by coordinating various aspects of a patient's healthcare needs. While reducing healthcare costs and implementing clinical guidelines are important goals in healthcare, the primary focus of a PCMH is on enhancing patient care coordination to improve outcomes and patient satisfaction. Providing financial incentives for providers is not the primary purpose of a PCMH, although it can be a component of some models to encourage quality care delivery.
5. A nurse manager wants to implement a new policy on the unit. What is the first step in the change process according to Lewin's Change Theory?
- A. Unfreeze the system
- B. Move the system to a new level
- C. Refreeze the system
- D. Evaluate the system
Correct answer: A
Rationale: The correct answer is A: 'Unfreeze the system.' According to Lewin's Change Theory, unfreezing the system is the initial step in the change process. This step involves preparing the organization for change by creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Choice B, 'Move the system to a new level,' is incorrect as it does not align with the first step of unfreezing. Choice C, 'Refreeze the system,' is incorrect as it pertains to the final stage of solidifying the change, not the first step. Choice D, 'Evaluate the system,' is incorrect as evaluation typically occurs after the change has been implemented, not at the beginning of the change process.
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