NURSING 390 Principles of Delegation and Priority Quiz Bank > Principles of Delegation and Priority Quiz Bank | Latest 2020 complete solutions/Rationales

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Principles of Delegation and Priority Quiz Bank Question 1 1 / 1 pts A client with leukemia is being considered for a bone marrow transplant. The healthcare team is discussing the risks and benefit... s of this treatment and other possible treatments with the goal of inflicting the least possible harm on the client. Which principle of healthcare ethics is the team practicing? Justice Fidelity Nonmaleficence Autonomy Rationale: Nonmaleficence is the avoidance of hurt or harm. Remember that in healthcare ethics, ethical practice involves not only the will to do good but also the equal commitment to do no harm. Healthcare professionals try to balance the risks and benefits of a plan of care while striving to do the least possible harm. Justice refers to fairness and equity and ensuring fair allocation of resources, such as nursing care for all clients. Fidelity is the keeping of promises made to clients, families, and other healthcare professionals. Autonomy refers to a person’s independence and represents an agreement to respect another’s right to determine his or her course of action. Test-Taking Strategy: Use the process of elimination and think about the definition of each item in the options. Note the relationship of the words “least possible harm” in the question and the definition of nonmaleficence. Review the principles of healthcare ethics if you had difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., p. 314). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 2 1 / 1 pts Which action by the nurse represents the ethical principle of beneficence? The nurse follows a plan of care designed to relieve pain in a client with cancer. The nurse upholds a client’s decision to refuse chemotherapy for lung cancer. The nurse administers an immunization to a child even though it may cause discomfort. The nurse provides equal amounts of care to all assigned clients on the basis of illness acuity. Rationale: Beneficence is taking action to help others. Although administration of a child’s immunization might cause discomfort, the benefits of protection from disease outweigh the temporary discomfort. Fidelity is keeping promises made to clients, families, and other healthcare professionals. Autonomy is a person’s independence. Respecting another’s autonomy means that you are agreeing to respect that person’s right to determine his or her course of action. Justice refers to fairness and equity, including fair allocation of resources, such as nursing care for all clients. Test-Taking Strategy: Focus on the subject, beneficence. Recalling that beneficence refers to taking action to help others will direct you to the correct option. Review the principles of healthcare ethics if you had difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., p. 314). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 3 1 / 1 pts The nursing instructor asks a student to name an example of false imprisonment. Which of the following situations reflects a violation of this client right? Threatening to give a client a medication against his or her will Telling the client that he or she may not leave the hospital Observing the provision of care to the client without the client’s permission Performing a procedure without consent Rationale: Telling a client that he or she may not leave the hospital constitutes false imprisonment. Performing a procedure without consent is an example of battery. Threatening to give a client a medication against his or her will is assault. Invasion of privacy takes place with unreasonable intrusion into an individual’s private affairs. Observing the provision of care to a client without the client’s permission is an example of invasion of privacy. Test-Taking Strategy: Focus on the subject, an example of false imprisonment. Note the relationship of the subject and the words in the correct option. If you had difficulty with this question, review the concept of false imprisonment. References: Cherry, B., & Jacob, S. (2008). Contemporary nursing issues: Trends & management (4th ed., pp. 175, 176). St. Louis: Mosby. Zerwekh, J., & Claborn, J. (2009). Nursing today: Transition and trends (6th ed., p. 424). Cognitive Ability: Evaluating Client Needs: Safe and Effective Care Environment Integrated Process: Teaching and Learning Content Area: Ethical/Legal Question 4 1 / 1 pts A nurse and a nursing assistant enter a client s room to provide care and find the client lying on the floor. The nurse should first: Ask the nursing assistant to complete an incident report Check the client s level of consciousness and vital signs Contact the unit secretary on the intercom and ask that the client s physician be called Ask the nursing assistant to assist in getting the client back to bed Rationale: When a client sustains a fall, the nurse must first assess the client. The nurse should check the client s level of consciousness and vital signs and look for any bruises or injuries sustained in the fall. If the nurse determines that the client has not sustained any injuries and that it is safe to move the client, the nurse should ask the nursing assistant to assist in getting the client into bed. The nurse should then contact the physician and file an incident report. Test-Taking Strategy: Note the strategic word first. Use the steps of the nursing process to answer the question. The correct option is the only one that addresses assessment. Remember to always assess the client first if a client sustains a fall. Review client injuries and procedures for filing incident reports if you had difficulty with this question. References: Ignatavicius, D., & Workman, M. (2010). Medical-surgical nursing: Patient centered collaborative care (6th ed., p. 180). St. Louis: Saunders. Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., p. 403). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Delegating/Prioritizing Question 5 1 / 1 pts Which of the following actions exemplifies the use of evidence-based practice in the delivery of client care? Taking a rectal temperature from a client for whom bleeding precautions have been instituted Advising a client to agree to the treatment recommended by her physician Donning sterile gloves to change an abdominal wound dressing Encouraging a client to take an herbal substance to treat his insomnia Rationale: Evidence-based practice is an approach to client care in which the nurse integrates the client’s preferences, clinical expertise, and the best research evidence to deliver quality care. Donning sterile gloves to change an abdominal wound dressing reflects evidence-based practice, because it prevents the entrance of harmful bacteria into the wound. The remaining options do not reflect evidence-based practice. Taking an herbal substance could be harmful to some clients. It is nontherapeutic for a nurse to advise a client to agree to a treatment. Because of the risk of injury to the rectal mucosa, rectal temperature-taking is avoided in the client for whom bleeding precautions have been instituted. Test-Taking Strategy: Read each option carefully, focusing on the subject, evidence-based practice. Recall the definition of evidence-based practice and note the words “sterile gloves” in the correct option. Review the situations that reflect evidence-based practice if you had difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., pp. 54-60). St. Louis: Mosby. Cognitive Ability: Understanding Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Leadership/Management Question 6 1 / 1 pts The registered nurse has accepted a new position as case manager in a hospital. Which of the following responsibilities are part of the nurse s new role? Select all that apply. Establishing a safe and cost-effective plan of care with the client Assessing the client s needs for home supplies and equipment Coordinating consultations and referrals to facilitate discharge Prescribing treatments specific to the client s needs Evaluating and updating the plan of care as needed Rationale: A case manager is a nurse who assumes responsibility for coordinating the client's care from the point of admission through, and after, discharge. Specific responsibilities of the case manager include establishing a safe and cost-effective plan of care with the client, coordinating consultations and referrals, and facilitating discharge; initiating a plan of nursing care, care map, or clinical pathway as appropriate to guide care and evaluating and updating the plan of care as needed; ensuring that the plan of care is tailored to the client s needs, taking into account the client s diagnosis, self-care ability, and prescribed treatments; assessing the client s need for equipment such as oxygen or wound care supplies and exploring available resources to provide the client with these supplies; providing resources that will assist the client in maintaining independence as much as possible; and providing the client with information on discharge procedures and the plan of care. The nurse does not prescribe treatments. Test-Taking Strategy: Focus on the subject, the responsibilities of the case manager. Note the word prescribing in the incorrect option. It is not within the role of the nurse to prescribe. Review the responsibilities of the case manager if you have difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., p. 21). St. Louis: Mosby. Cognitive Ability: Understanding Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Leadership/Management Question 7 1 / 1 pts The nurse manager of a quality improvement program asks a nurse in the neurological unit to conduct a retrospective audit. Which of the following actions should the auditing nurse plan to perform in this type of audit? Obtaining the assigned medical record from the hospital’s medical record room to review documentation made during a client’s hospital stay Checking the crash cart to ensure that all needed supplies are readily available should an emergency arise Reviewing neurological assessment checklists for all clients on the unit to ensure that these assessments are being conducted as prescribed Checking the documentation written by a new nursing graduate on her assigned clients at the end of the shift Rationale: Quality improvement, also known as performance improvement, is focused on processes or systems that significantly contribute to client safety and effective client care outcomes. Criteria are used to assess outcomes of care and determine the need for changes improve the quality of care. In a retrospective, or “looking back,” audit, the medical record is inspected after the client’s discharge for documentation of compliance with standards. In a concurrent, or “at the same time,” audit, the nursing staff’s compliance with predetermined standards and criteria is assessed as the nurses are providing care during the client’s stay. In this type of audit, a peer review approach in which members of the nursing staff are involved in data collection may be implemented. Obtaining the a client’s medical record from the medical record room for the purpose of reviewing documentation made during the client’s hospital stay is an example of a retrospective audit. The incorrect options are examples of concurrent audits. Test-Taking Strategy: Focus on the subject, a retrospective audit. Note the relationship of the word “retrospective” in the question and the description in the correct option. Review the procedures for quality improvement and retrospective and concurrent audits if you have difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., pp. 64, 65). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Planning Content Area: Leadership/Management Question 8 1 / 1 pts A nurse preparing a client for a bronchoscopy notes that the client is wearing a gold necklace. What should the nurse do to safeguard the client s necklace? Ask the client for permission to lock the necklace in the hospital safe Ask the client to sign a release to free the hospital of responsibility if the necklace is damaged or lost during the procedure Ask the client to remove the necklace and place it in the top drawer of the bedside table Ask the client whether the necklace is gold Rationale: When a client has valuables, the nurse should give them to a family member or secure them for safekeeping. Most healthcare institutions require that a client sign a release form that frees the institution of responsibility if a valuable item (e.g., jewelry, money) is lost, but this does not safeguard the client s necklace. Valuables may be locked in a designated location such as the hospital s safe. Removing the necklace and putting it in a drawer does not safeguard it. Asking the client whether the necklace is gold is inappropriate and unrelated to the subject. Test-Taking Strategy: Use the process of elimination and focus on the subject, safeguarding the client s necklace. Focusing on the subject and noting the word lock in the correct option will help you answer correctly. Review the procedures for safeguarding a client s valuables if you had difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., p. 1387). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 9 1 / 1 pts A nurse providing preoperative care to a client who is scheduled for a left mastectomy and axillary lymph node dissection notes that the client is wearing a wedding band on her left ring finger. The nurse should: Tape the wedding band in place Ask the client to sign a release to free the hospital of responsibility if the wedding band is lost during surgery Ask the client whether she would like to remove the wedding band or wear it to surgery Explain to the client why the wedding band must be removed Rationale: In most situations a wedding band may be taped in place and worn during a surgical procedure. However, if the possibility exists that the client will experience swelling of the hand or fingers, the wedding band should be removed. On admission to a healthcare facility, the client is asked to sign a form that frees the agency from responsibility if a client s valuable is lost. After mastectomy with axillary lymph node dissection, the client is at risk for lymphedema, which results in swelling of the arm and hand on the affected side. Therefore the appropriate nursing action is to ask the client to remove the wedding band and explain why. Test-Taking Strategy: Use the process of elimination and focus on the data in the question. Eliminate the options that are comparable or alike in that they indicate that the client may wear the wedding band during the surgical procedure. Next, recall the complications associated with mastectomy, which will direct you to the correct option. Review preoperative procedures for a client s valuables if you had difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., p. 1387). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Perioperative Care Question 10 1 / 1 pts A nurse preparing a client to go to the radiology department for a chest x-ray notes that the client is wearing a religious medal on a chain around the neck. The client, a Catholic, expresses a concern about removing the medal. What is the most appropriate action for the nurse to take? Telling the client that the medal and chain will be kept at the nurses’ station for safekeeping while the client is undergoing the x-ray Asking the client to place the medal in the top drawer of the bedside stand just before leaving for the radiology department Asking the client to remove the medal until the x-ray has been completed Assisting the client in pinning the medal and chain to the waistband of the client’s pajama bottoms Rationale: A client undergoing a chest x-ray must remove all metal objects to help prevent artifacts on the x-ray. If the client expresses concern about removing the medal, the nurse should help the client pin the medal and chain to the hospital gown or in another area where it will not appear on the x-ray image. The nurse should also alert staff in the radiology department that this has been done. If the client is expressing concern about removing the medal, asking the client to remove it or leave it with the nurse or in the bedside stand is inappropriate. Each of these actions also increases the likelihood that the medal and chain will be lost. Test-Taking Strategy: Use the process of elimination and note that the client is expressing concern about removing the religious medal. Eliminate the options that are comparable or alike in that they indicate that the client should remove the medal. Also note that the correct option is the only option that addresses the client’s concern. Review care of clients’ valuables if you had difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., p. 1387). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Safety Question 11 1 / 1 pts A physician writes a medication prescription in a client s record. While transcribing the prescription, the nurse notes that the prescribed dose is three times higher than the recommended dose. The nurse calls the physician, who states that this is the dose that the client takes at home and that it is acceptable for this client s condition. What is the appropriate action for the nurse to take? Contacting the nursing supervisor Verifying the prescribed dose with the client before administering the medication Continuing to transcribe the prescription Asking the nurse assigned to care for the client to administer the medication Rationale: A nurse must follow a physician s prescription unless he or she believes that the prescription is in error or that it would harm the client. If a prescription is found to be incorrect or harmful, further clarification from the physician is necessary. If the physician confirms the prescription and the nurse still believes that it is inappropriate, the nurse should contact the nursing supervisor. The nurse should not continue transcribing the prescription or ask another nurse to implement the prescription. The nurse might ask the client about the medication and the dose taken at home but would not administer the medication. Test-Taking Strategy: Use the process of elimination. Eliminate the options that are comparable or alike in that they indicate that the medication would be administered. Review the nurse s responsibilities in regard to a physician s prescriptions if you had difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., p. 709). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 12 1 / 1 pts A nurse monitoring a client with a chest tube notes that there is no tidaling of fluid in the water seal chamber. After further assessment, the nurse suspects that the client s lung has reexpanded and notifies the physician. The physician verifies with the use of a chest x-ray that the lung has reexpanded, then calls the nurse to asks that the chest tube be removed. The nurse should first: Inform the physician that removal of a chest tube is not a nursing procedure Obtain petrolatum-impregnated gauze and ask another nurse to assist in removing the chest tube Explain the procedure to the client, then remove the chest tube Call the nursing supervisor Rationale: Actual removal of a chest tube is the duty of a physician. Therefore the nurse would first inform the physician that this is not a nursing procedure. If the physician insists that the nurse remove the tube, the nurse must contact the nursing supervisor. Some agency s policies and procedures may permit an advanced practice nurse (a nurse with a master s degree in a specialized area of nursing) to remove a chest tube. However, there is no information in the question to indicate that the nurse is an advanced practice nurse. Test-Taking Strategy: Use the process of elimination. Eliminate the options that are comparable or alike in that they indicate that the nurse would remove the chest tube. To select from the remaining options, note the strategic word first. The nurse should discuss the prescription with the physician. Review nursing responsibilities with regard to removal of a chest tube if you had difficulty with this question. Reference: Black, J., & Hawks, J. (2009). Medical-surgical nursing: Clinical management for positive outcomes (8th ed., p. 1624). St. Louis: Saunders. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 13 1 / 1 pts A nurse calls a physician to report that a client with congestive heart failure (CHF) is exhibiting dyspnea and worsening of wheezing. The physician, who is in a hurry because of a situation in the emergency department, gives the nurse a telephone prescription for furosemide (Lasix) but does not specify the route of administration. What is the appropriate action on the part of the nurse? Calling the physician who gave the telephone prescription to clarify the prescription Administering the medication intravenously, because this route is generally used for clients with CHF Calling the nursing supervisor for assistance in determining the route of administration Administering the medication orally and clarifying the prescription once the physician has finished caring for the client in the emergency department Rationale: Telephone prescriptions involve a physician’s dictating a prescribed therapy over the telephone to the nurse. The nurse must clarify the prescription by repeating the prescription clearly and precisely to the physician. The nurse then writes the prescription on the physician’s prescription sheet. Under no circumstances should the nurse try to interpret an unclear prescription or administer a medication by a route that has not been expressly prescribed. The nurse must call the physician who gave the telephone prescription and clarify the prescription. Test-Taking Strategy: Use the process of elimination. Eliminate the options that are comparable or alike in that they indicate that the nurse should administer the medication without clarifying the physician’s prescription. Review the procedures for accepting telephone prescriptions if you had difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., pp. 699, 700). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 14 1 / 1 pts A nurse is assisting a physician in assessing a hospitalized client. During the assessment, the physician is paged to report to the recovery room. The physician leaves the client’s bedside after giving the nurse a verbal prescription to change the solution and rate of the intravenous (IV) fluid being administered. What is the appropriate nursing action in this situation? Telling the physician that the prescription will not be implemented until it is documented in the client’s record Asking the physician to write the prescription in the client’s record before leaving the nursing unit Calling the nursing supervisor to obtain permission to accept the verbal prescription Changing the solution and rate of the IV fluid per the physician’s verbal prescription Rationale: The physician should write all prescriptions. Verbal prescriptions are not recommended, because they increase the risk for error. If a verbal prescription is necessary, such as during an emergency, it should be written and signed by the physician as soon as possible, usually within 24 hours. The nurse must follow agency policies and procedures regarding verbal prescriptions. The appropriate nursing action would be to ask the physician to write the prescription in the client’s record before leaving the nursing unit. Changing the solution in keeping with the verbal prescription and contacting the supervisor to obtain permission to accept the verbal prescription each imply that the nurse accepts the verbal prescription. Telling the physician that the prescription will not be implemented until it is documented in the client’s record delays necessary treatment. Test-Taking Strategy: Use the process of elimination and note the strategic word “appropriate.” Eliminate the options that are comparable or alike in that they imply acceptance of the verbal prescription by the nurse. To select from the remaining options, recall the guidelines and principles for implementing physician prescriptions. This will direct you to the correct option. Review nursing responsibilities related to verbal prescriptions if you had difficulty with this question. Reference: Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., pp. 699, 700). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 15 1 / 1 pts A client scheduled for surgery tells the nurse that he signed an informed consent for the surgical procedure but was never told about the risks of the surgery. The nurse serves as the client’s advocate by: Calling the surgeon and asking that the risks be explained to the client Reassuring the client that the risks are minimal Noting in the client’s record that the client was not told about the risks of the surgery Writing a note on the front of the client’s record so that the surgeon will see it when the client arrives in the operating room Rationale: A nurse serves as a client advocate by protecting the right of the client to be informed and to participate in decisions regarding care. The only option that ensures that the client will be informed of the risks of the surgery is contacting the surgeon and asking that the risks be explained to the client. Telling the client that the risks are minimal is false reassurance. Putting a note on the client’s chart or documenting that the client was not informed about the risks does ensure that the client will be informed. Test-Taking Strategy: Use the process of elimination and guidelines and principles of obtaining informed consent. Focusing on the words “never told about the risks of the surgery” will direct you to the correct option, the only option that ensures that the client will be told about the risks. Review the role of a nurse as a client advocate if you had difficulty with this question. References: Cherry, B., & Jacob, S. (2008). Contemporary nursing issues: Trends & management (4th ed., p. 179). St. Louis: Mosby. Potter, P., & Perry, A. (2009). Fundamentals of nursing (7th ed., pp. 352-357). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 16 1 / 1 pts A nurse is planning to administer an oral antibiotic to a client with a communicable disease. The client refuses the medication and tells the nurse that the medication causes abdominal cramping. The nurse responds, “The medication is needed to prevent the spread of infection, and if you don’t take it orally I will have to give it to you in an intramuscular injection.” Which of the following statements accurately describes the nurse’s response to the client? The nurse could be charged with battery. The nurse will be justified in administering the medication by the intramuscular route once a prescription has been obtained from the physician. The nurse is justified in administering the medication by way of the intramuscular route, because the client has a communicable disease. The nurse could be charged with assault. Rationale: Assault is an intentional threat to bring about harmful or offensive contact. If a nurse threatens to give a client a medication that the client refuses or threatens to give a client an injection without the client’s consent, the nurse may be charged with assault. Therefore the nurse is not justified in administering the medication. Battery is any intentional touching without the client’s consent. Test-Taking Strategy: Focus on the data in the question and the nurse’s statement. Note that the nurse threatens the client. Next, recall the definition of assault, which will direct you to the correct option. Review violations of client rights if you had difficulty with this question. Reference: Cherry, B., & Jacob, S. (2008). Contemporary nursing issues: Trends & management (4th ed., pp. 172, 173). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 17 1 / 1 pts A nurse discovers that another nurse has administered an enema to a client even though the client told the nurse that he did not want one. The most appropriate action for the nurse is to: Confront the nurse who gave the enema and tell the nurse that she is going to be charged with battery Tell the client that the nurse did the right thing in giving the enema Report the incident to the nursing supervisor Contact the client s physician Rationale: Battery is any intentional touching of a client without the client s consent. Such contact may be harmful to the client or it may merely be offensive to the client s dignity. If a nurse discovers that battery of a client has occurred, the nurse should report the situation to the nursing supervisor. Telling the client that the nurse did the right thing in giving the enema is incorrect, because the other nurse has violated the client s rights. Confronting the nurse and telling her that she is going to be charged with battery would likely result in unnecessary conflict. Although the physician may need to be notified, the nurse should first report the situation to the nursing supervisor. Test-Taking Strategy: Use the process of elimination and note the strategic words most appropriate. Next, focus on the subject, client rights. Recalling that any situation that constitutes a violation of a client s rights needs to be reported and remembering the organizational channels of reporting will direct you to the correct option. Review the issues surrounding violation of client rights and nursing responsibilities when a client s rights have been violated if you had difficulty with this question. Reference: Cherry, B., & Jacob, S. (2008). Contemporary nursing issues: Trends & management (4th ed., pp. 172, 173). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 18 1 / 1 pts A nurse calls a physician to question a prescription written for a higher-than-normal dosage of morphine sulfate. The physician changes the prescription to a dosage within the normal range, and the nurse documents the new telephone prescription in accordance with the agency s guidelines in the client s record. Which other statement does the nurse document in the nursing notes? An incorrect dosage of morphine sulfate was prescribed and the physician was notified. The physician was called to correct an error in the dosage of morphine sulfate. The physician was called to clarify the prescription for morphine sulfate. The physician made an error in the written prescription for morphine sulfate. Rationale: The nurse needs to document a factual, descriptive, and objective statement that does not include words indicating that an individual made an error or performed an incorrect action or procedure. If a physician s prescription must be questioned, the nurse should record that clarification regarding the prescription was sought. Test-Taking Strategy: Use the process of elimination. Eliminate the options that are comparable or alike in that they indicate that the physician made an error in writing a prescription. These options contain the words error or incorrect. Review the principles of documentation if you had difficulty with this question. Reference: Cherry, B., & Jacob, S. (2008). Contemporary nursing issues: Trends & management (4th ed., pp. 388-390). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Ethical/Legal Question 19 1 / 1 pts A charge nurse on the 11 pm–to–7 am shift is gathering the nursing staff together to listen to the 3-to-11 pm intershift report. The charge nurse notes that a staff member has an odor of alcohol on her breath, slurred speech, and an unsteady gait and suspects alcohol intoxication. The charge nurse would most appropriately: Ask the staff member to rest in the nurses’ lounge until the effects of the alcohol wear off Ask the staff member how much alcohol she has consumed Tell the staff member that she is not allowed to administer medications Send the staff member home Rationale: When a staff member reports to work in a state of alcohol intoxication, the nurse notes the signs objectively and asks a second person to validate these observations. The nurse also contacts the nursing supervisor. An odor of alcohol, slurred speech, unsteady gait, and errors in judgment are symptoms of intoxication. Client safety is the primary concern. The intoxicated nurse is removed from the situation, confronted briefly and firmly about the behavior, and sent home to rest and recuperate. The incident is recorded and the nurse describes the observations, states the action taken, indicates future plans, and has the staff member sign and date the memo of the recorded incident after returning to work. Refusal to sign and date the memo should be noted by the charge nurse and a witness. Neither asking the staff member to rest in the nurses’ lounge until the effects of the alcohol wear off nor telling the staff member that he or she will not be allowed to administer medications removes the staff member from the client care area, jeopardizing the client’s safety. Asking the staff member how much alcohol she has consumed is confrontational and irrelevant. Test-Taking Strategy: Use the process of elimination, keeping in mind that client safety is the priority. Asking the staff member how much alcohol she has consumed is irrelevant, so eliminate this option. Next eliminate the options that are comparable or alike in that they do not involve removal of the staff member from the client care area. Review nursing responsibilities when substance abuse is suspected in a staff member if you had difficulty with this question. Reference: Marriner-Tomey, A. (2009). Guide to nursing management and leadership (8th ed., pp. 445, 446). St. Louis: Mosby. Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process/Implementation Content Area: Leadership/Management Question 20 1 / 1 pts A client asks a nurse about the procedure for becoming an organ donor. The nurse tells the client: To let the physician know about the request so that it may be documented in the client’s record That anatomical gifts must be made in writing and signed by the client To speak with the chaplain about the psychosocial aspects of becoming a donor That this decision must be made by the next of kin at the time of the client’s death >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>CONTINUED>>>>>>>>>>>>>>>>>>> [Show More]

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