Nursing Elites

1. A nurse is providing end-of-life care to an older female client who practices Judaism. Which intervention would the nurse identify as potentially problematic for this client and her family?

• A. The client requires transfusions of packed red blood cells during care.
• B. Assessment by a male health care provider was required.
• C. An autopsy was ordered due to the client's unique disease etiology.
• D. A do-not-resuscitate (DNR) order was recommended by the care team.

Correct answer: C

Rationale: The correct answer is C. Autopsy is often opposed in the context of Jewish religious and cultural beliefs, as it is seen as desecration of the body. While a person who is a Jehovah's Witness would be opposed to blood transfusions (choice A), a Muslim client may prefer to be cared for by someone of the same gender (choice B). A DNR order (choice D) is not noted to be a particular issue in the context of Jewish culture.

2. How does guardianship differ from power of attorney?

• A. The court appoints a guardian; an individual grants a power of attorney to someone else to make decisions on his or her behalf.
• B. Guardianship is legally binding whether or not an individual is competent; power of attorney applies only to the incompetent.
• C. Courts monitor the actions of those executing a power of attorney, but guardians are free to act on behalf of another as long as standards of 'reasonable prudence' are met.
• D. Guardianship stays in effect for one calendar year and must be renewed annually; power of attorney stays in effect until one or both parties choose to revoke it.

Correct answer: A

Rationale: The correct answer is A. The key difference between guardianship and power of attorney is that the court appoints a guardian to make decisions on behalf of an individual who is deemed incompetent, while an individual grants a power of attorney to someone else to make decisions on their behalf when they are competent. Choice B is incorrect because both guardianship and power of attorney can apply to individuals who are competent or incompetent. Choice C is incorrect as guardians, like those with power of attorney, must act in the best interest of the individual they represent, and the level of oversight can vary. Choice D is incorrect as guardianship and power of attorney do not have fixed time limits; they remain in effect until revoked or ended by the appropriate legal process.

3. What is a standard of care?

• A. A relationship in which a nurse has assumed responsibility for the care of a patient
• B. A policy or procedure established by a health care agency or professional association
• C. The norm for what a reasonable individual would do in a similar circumstance
• D. A public law that, if violated, can result in liability for the nurse

Correct answer: C

Rationale: A standard of care is the level of care that a reasonably prudent person with similar training and experience would provide in a similar circumstance. Choice A is incorrect because it describes the nurse-patient relationship. Choice B is incorrect as it refers to specific policies or procedures. Choice D is incorrect as it describes a law rather than the expected level of care.

4. A nurse has been providing care for a 69-year-old female client who has recently had her right foot amputated as a result of a chronic diabetic foot ulcer. The nurse undertook to perform debridement of the wound despite her lack of relevant education and experience. The client experienced permanent nerve damage as a result of the nurse's misguided efforts. Which category of legal liability is most likely relevant in this case?

• A. Larceny
• B. Assault
• C. Invasion of privacy
• D. Negligence

Correct answer: D

Rationale: In this case, the most likely relevant category of legal liability is negligence. Negligence involves the commission of an improper act, as exemplified by the nurse's actions of performing a procedure without the necessary education and experience, leading to permanent nerve damage for the client. Larceny refers to theft, assault involves a deliberate threat to harm, and invasion of privacy pertains to the violation of a person's right to privacy. Therefore, in this scenario, the nurse's actions align more closely with negligence.

5. A nurse is working in an assisted living facility that has a culturally diverse older adult population. Which statement by the nurse best demonstrates cultural sensitivity?

• A. We need to ensure that both the minority population and the majority population have their health needs met.
• B. It's important to remember that minority groups do not usually express their pain explicitly.
• C. We need to build our knowledge of clients who belong to cultural and ethnic groups that we're not familiar with.
• D. We need to teach all clients that their health problems are not necessarily the result of punishment.

Correct answer: C

Rationale: The best demonstration of cultural sensitivity by the nurse is reflected in choice C. Building a knowledge base around cultural and ethnic groups is a crucial component of providing culturally sensitive care. Choice A creates an inaccurate dichotomy between 'minority' and 'majority' populations, which is not a culturally sensitive approach. Choice B incorrectly generalizes that minority groups do not usually express their pain explicitly, which is not true for all cultural groups. Choice D suggests imposing a different belief system on clients, which is not culturally sensitive and can undermine trust and rapport with older adult clients.

Similar Questions