Nursing Elites

1. What might a nurse suggest to help the grown children make the most of their limited incomes and time with their parents?

• A. Help them find nearby spots for picnics or other free outings
• B. Refer the family to a more appropriate practitioner
• C. Suggest they take out a second mortgage on the family house
• D. Encourage the entire family to participate in activities at Haven

Correct answer: A

Rationale: A nurse, as a caring worker, may suggest helping the grown children find nearby spots for picnics or other free outings. This suggestion would allow the parents to get out of the facility and enjoy quality time with their children without any financial burden. While the family may also want to participate in activities at the facility, a picnic would provide a change of scenery. Referring the family to a more appropriate practitioner is not relevant to improving the limited incomes and time spent with the parents. Suggesting to take out a second mortgage on the family house could provide temporary financial relief but may not be the most suitable solution for maximizing time spent with the parents.

2. Nurse R works on the geriatric medicine unit of the university hospital and provides care for numerous older adult clients nearing the end of life, many of whom have no-code orders. Which of the following situations is incompatible with the legal requirements for a no-code order?

• A. A client who is mentally competent has declared his wish to have a no-code order despite the availability of treatment options for his condition.
• B. A client has expressed her desire to have a no-code order but her daughter is adamantly opposed to it.
• C. A client clearly tells the nurse her desire to have a no-code order, which the nurse documents at the bedside.
• D. A client has been in a coma and the family has decided to put in place a no-code order.

Correct answer: C

Rationale: The correct answer is C. No-code orders require a written and signed order by a physician. Therefore, a client expressing the desire for a no-code order to a nurse, without a documented physician's order, is incompatible with legal requirements. Choices A and B are not incompatible as competent clients can make their own decisions, regardless of treatment options or family opposition. Choice D is also not incompatible as family decisions can be made on behalf of incompetent clients.

3. A nurse is determining ways to address ethnic diversity among clients being provided care. Which action would be the most direct way for the nurse to do this?

• A. Explain how cultural backgrounds influence health beliefs and practices.
• B. Provide culturally sensitive care that respects clients' traditions.
• C. Listen to the life stories of clients to understand their cultural influences.
• D. Participate in cultural competency training and workshops.

Correct answer: C

Rationale: Listening to the life stories of clients is an effective way for nurses to understand the cultural influences that shape their beliefs and practices. By actively listening, nurses can gain insight into the clients' backgrounds, values, and preferences, allowing them to provide more personalized and culturally sensitive care. Choices A, B, and D are not as direct as listening to the life stories of clients. While explaining how cultural backgrounds influence health beliefs and practices is important, directly listening to clients' life stories provides a deeper understanding of their individual cultural influences.

4. Nurse B arrives for his regular night shift at a care facility for the aged. Due to a family emergency, he has only slept for 3 hours since his last shift. One of Nurse B's aides calls in sick, and there is no one available to replace the aide that night. With no help accessible, Nurse B lifts an obese patient from a wheelchair into a bed alone. Short on time and assistance, Nurse B decides to forgo the patient's evening bath. Legally, what does Nurse B most likely face?

• A. Little risk of liability because he is doing his best under difficult circumstances
• B. Immediate termination for dereliction of duty
• C. Liability if a pattern of negligence is identified in his performance evaluation
• D. A high risk of liability for his actions

Correct answer: D

Rationale: In this scenario, Nurse B faces a high risk of liability for his actions due to several factors. Working with insufficient resources, failing to adhere to policies and procedures, taking shortcuts, and working while highly stressed are all situations that increase the risk of liability. Nurse B's decision to lift an obese patient without assistance and skip the patient's evening bath due to time constraints and lack of help are clear examples of actions that can lead to legal consequences. Choices A, B, and C are incorrect because the circumstances described in the scenario indicate a higher likelihood of liability due to the factors mentioned above.

5. An older adult client from a minority culture refuses to eat at the nursing home, stating, 'I just do not like the food here.' What factor should the staff assess for this problem?

• A. The client does not like eating with other residents of the home.
• B. The client is using this as an excuse to go home.
• C. The food served may not be culturally appropriate.
• D. The food served may violate religious beliefs.

Correct answer: C

Rationale: The correct answer is C. Residents in long-term care settings often have limited food choices, which may not align with their cultural preferences. When assessing why a client is refusing to eat, it is essential to consider if the food served is culturally appropriate. Choices A, B, and D are incorrect. There is no indication in the scenario that the client's refusal to eat is due to not liking to eat with other residents, using it as an excuse to go home, or violating religious beliefs.

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