Nursing Elites

1. In which of the following situations would the use of physical restraints most likely be justified?

• A. Mr. Y is agitated and aggressive while experiencing severe alcohol withdrawal and is not responding to chemical sedation.
• B. Mrs. U, diagnosed with dementia, was found wandering outside the hospital, and nurses have been unable to redirect her to stay on the unit.
• C. Mr. I is delirious during the acute stage of his urinary tract infection and is ringing the call bell nearly continuously.
• D. Mrs. T is frequently entering other patients' rooms and attempting to crawl into others' beds.

Correct answer: A

Rationale: Answer A is the correct choice because it describes a situation where the client poses a risk due to agitation and aggression during severe alcohol withdrawal, and chemical sedation has not been effective. In such cases, physical restraints may be justified as a last resort to ensure the safety of the client and others. Choices B, C, and D present scenarios where alternative strategies like redirection, addressing delirium, or implementing behavioral interventions should be attempted before considering physical restraints.

2. A local community has a small budget for community health programs aimed specifically toward its black population. Which type of community health program will the nurse recommend as the best use of the budget?

• A. depression screening
• B. meal planning
• C. blood pressure screening
• D. sleep disorder information

Correct answer: C

Rationale: The best use of the budget for the black population in the local community would be blood pressure screening. Hypertension is a prevalent health issue among black Americans, occurring at a higher rate than in the white population. Therefore, focusing on blood pressure screening would help in early detection and management of hypertension within this community. Depression screening and sleep disorder information are not the priority as there is not a higher incidence of these conditions in older black clients. Meal planning could be beneficial for clients with diabetes, but it may not be the most critical focus considering the higher prevalence of hypertension among the black population.

3. Which of the following is a matter of public, not private, law?

• A. Wrongful acts against another party
• B. Invasion of a patient's privacy
• C. Assault and battery on a patient
• D. Licensing of a home health agency

Correct answer: D

Rationale: The correct answer is D, 'Licensing of a home health agency.' Public law governs relationships between private parties and the government, such as licensing requirements for entities like home health agencies. Choices A, B, and C involve private law, which governs relationships between individuals and organizations. These choices pertain to wrongful acts against another party, invasion of privacy, and assault and battery, respectively.

4. 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.

5. A nurse at a rehabilitation center is preparing a care plan for a 71-year-old post-stroke patient who has shown significant improvement in function and who is ready to return to the community. In the nurse's efforts to mobilize family caregiving, which of the following statements provides the most accurate criterion for inclusion in the category of 'family'?

• A. The patient's spouse, biological children, and closest friends
• B. Any unpaid person who has expressed sincere interest in the patient's condition and provided hands-on care since his admission to the facility
• C. Anyone who self-identifies as being a member of the patient's family
• D. Any individual who fulfills the patient's family functions

Correct answer: D

Rationale: The most accurate criterion for inclusion in the category of 'family' when mobilizing family caregiving is identifying individuals who fulfill family functions. Choice D is the correct answer as it emphasizes the importance of individuals who perform essential family functions for the patient. This criterion is crucial as it prioritizes the practical support and care provided by individuals over biological relationships (Choice A), self-identification (Choice C), or willingness to provide care (Choice B), which may not always translate to fulfilling necessary family functions.

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