Which of the following signs and symptoms would the nurse expect to find when assessing an Asian patient for postoperative pain following abdominal surgery?
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Solution
Option C: An Asian patient is likely to hide his pain. Consequently, the nurse must observe for objective signs. In an abdominal surgery patient, these might include immobility, diaphoresis, and avoidance of deep breathing or coughing, as well as increased heart rate, shallow respirations (stemming from pain upon moving the diaphragm and respiratory muscles), and guarding or rigidity of the abdominal wall. Such a patient is unlikely to display emotion, such as crying.
Which of the following is an example of nursing malpractice?
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Solution
Option A: The three elements necessary to establish a nursing malpractice are nursing error (administering penicillin to a patient with a documented allergy to the drug), injury (cerebral damage), and proximal cause (administering the penicillin caused the cerebral damage).
Option B: Applying a hot water bottle or heating pad to a patient without a physician’s order does not include the three required components.
Option C: Assisting a patient out of bed with the bed locked in position is the correct nursing practice; therefore, the fracture was not the result of malpractice.
Option D: Administering an incorrect medication is a nursing error; however, if such action resulted in a serious illness or chronic problem, the nurse could be sued for malpractice.
A registered nurse reaches to answer the telephone on a busy pediatric unit, momentarily turning away from a 3 month-old infant she has been weighing. The infant falls off the scale, suffering a skull fracture. The nurse could be charged with:
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Solution
Option D: Malpractice is defined as injurious or unprofessional actions that harm another. It involves professional misconduct, such as omission or commission of an act that a reasonable and prudent nurse would or would not do. In this example, the standard of care was breached; a 3-month-old infant should never be left unattended on a scale.
If patient asks the nurse her opinion about a particular physicians and the nurse replies that the physician is incompetent, the nurse could be held liable for:
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Solution
Option A: Oral communication that injures an individual’s reputation is considered slander.
Option B: Written communication that does the same is considered libel.
If nurse administers an injection to a patient who refuses that injection, she has committed:
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Solution
Option A: Assault is the unjustifiable attempt or threat to touch or injure another person. Battery is the unlawful touching of another person or the carrying out of threatened physical harm. Thus, any act that a nurse performs on the patient against his will is considered assault and battery.
Which of the following principles of primary nursing has proven the most satisfying to the patient and nurse?
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Solution
Option D: Studies have shown that patients and nurses both respond well to primary nursing care units. Patients feel less anxious and isolated and more secure because they are allowed to participate in planning their own care. Nurses feel personal satisfaction, much of it related to positive feedback from the patients. They also seem to gain a greater sense of achievement and esprit de corps.
A new head nurse on a unit is distressed about the poor staffing on the 11 p.m. to 7 a.m. shift. What should she do?
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Solution
Option C: Although a new head nurse should initially spend time observing the unit for its strengths and weakness, she should take action if a problem threatens patient safety. In this case, the supervisor is the resource person to approach.
The family of an accident victim who has been declared brain-dead seems amenable to organ donation. What should the nurse do?
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Solution
Option B: The brain-dead patient’s family needs support and reassurance in making a decision about organ donation.
Option A: Because transplants are done within hours of death, decisions about organ donation must be made as soon as possible.
Option C: However, the family’s concerns must be addressed before members are asked to sign a consent form.
Option D: The body of an organ donor is available for burial.
In Maslow’s hierarchy of physiologic needs, the human need of greatest priority is:
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Solution
Option D: Maslow, who defined a need as a satisfaction whose absence causes illness, considered oxygen to be the most important physiologic need; without it, human life could not exist.
Options A, B, and C: According to this theory, other physiologic needs (including food, water, elimination, shelter, rest and sleep, activity and temperature regulation) must be met before proceeding to the next hierarchical levels on psychosocial needs.
The four main concepts common to nursing that appear in each of the current conceptual models are:
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Solution
Option D: The focus concepts that have been accepted by all theorists as the focus of nursing practice from the time of Florence Nightingale include the person receiving nursing care, his environment, his health on the health illness continuum, and the nursing actions necessary to meet his needs.