A pt family requests to stay beyond visiting hours. The nurse best response
is to
A. determine the pt wishes
B. explain the need to adhere to the visiting policy
C. allow a longer stay
D. encourage the family to leave - Correct Answer - A. Evidence shows
that the unrestricted presence and participation of a support person can
enhance patient and family satisfaction, because it improves the safety of
care. Unrestricted presence of a support person can improve
communication, facilitate a better understanding of the pt, advance pt and
family centered care, and enhance staff satisfaction. Determining what the
pt prefers is the first step and is consistent with caring practices in the
Synergy Model.
A pt states that he works the night shift, is accustomed to taking his
medications at night instead of in the morning and needs to get back on his
regular schedule. The first dose is schedule. The first dose is scheduled for
0900. The most appropriate response would be to
A. explain the importance of maintaining a routine administration time to the
pt
,B. ask the pharmacist to provide education and information on BP
medication to the pt
C. remind the pt that he will not be working after his discharge, and
recommend follow-up at hist first postoperative appointment
D. contact the pharmacy and request that administration times be changed
to meet the pt individual needs - Correct Answer - D. Consistent with
caring practices, participation in care and participation in decision making in
the Synergy Model, his wishes should be granted. The pt medication
schedule should not be modified accordingly, unless contraindicated
A fellow employee confides to you about a personal addiction to narcotics.
The colleague has not sought professional help but is considering the need
to do so. Conversation further reveals she has been forging prescriptions to
obtain drugs. When you ask her to report this to the supervisor, she refuses
and asks you not to share what you spoke about. What is the nurse best
course of action
A. confidentially report the conversation to the EDA
B. disregard the conversation and hope the situation resolves
C. remove the prescription pads and limit her access to them
D. speak with the nursing supervisor - Correct Answer - D. Nurses who
divert drugs pose a significant threats to patient safety but also become a
liability to healthcare organizations and the nursing department where the
diversion occurred. Healthcare and nursing leaders have a responsibility to
ensure that security systems are in place to prevent diversion and protect
pt if nursing impairment is suspected as a result of drug diversion. Nursing
leaders must consider legal, regulatory, ethical, humanistic and practical
,considerations in resolving this issue. The nursing supervisor must be
notified immediately and in a private area. This is a very sensitive issue.
A pt with chronic alcohol abuse is admitted with altered mental status. The
pt has periods of clear sensorium but has frequent episodes of agitation
accompanied by diaphoresis, nausea and vomiting. The nurse notes
increased muscle weakness and new onset of first-degree AV block. Which
of the following is indicated at this time
A. collaborate with the physician for a neuro consult
B. check the pt magnesium level
C. perform a 12 lead ECG
D. institute seizure precautions - Correct Answer - B. This pt has a risk
factor (chronic alcohol abuse) and symptoms of hypomagnesemia.
A pt with an extensive history of ACS is admitted with an acute
exacerbation of heart failure. Data are as follows
Bp 90/60, HR 120, O2 sat 90% on 4l via nasal cannula
She has diffuse crackles throughout all lung fields. The physician has
ordered diuretics and insertion of a central line for dobutamine
administration. Her husband favors withdrawal of treatment but the pt has
indicated she wants to continue treatment even if its painful and possibly
futile. She is oriented to person and place but disoriented to time and year.
The nurse should recognize
A. the pt wishes should be supported under the ethical principle of
autonomy
B. the pt should be educated that comfort can be maintained for her even
without further treatment
, C. the pt cognition may be impaired because of hypoxia and decreased
blood pressure, and the husband should make medical decisions
D. that the spiritual care should be consulted before healthcare d - Correct
Answer - A. As an advocate and moral agent, the nurse must support the
pt wishes as long as the pt has capacity, which is the case in this scenario.
A pt who is visually impaired is to be transferred to another unit. The nurse
should prepare the pt for the transition by
A. explaining the physical layout of the receiving unit to the pt
B. advising the staff on the receiving unit to orient the pt
C. providing written materials about the receiving unit to the pt family
D. arranging for the pt family to tour the receiving unit - Correct Answer -
A. Preparing the pt for transfer by providing information about the receiving
unit may help alleviate transfer anxiety.
Which of the following leads should be used for ST segment monitoring in a
pt with suspected ACS
A. III or V5
B. II or V1
C. I or aVL
D. II or aVF - Correct Answer - A. For pt without definite ACS but
suspected ACS, leads III and V5 should be monitored.
The authority of a surrogate speak for a pt should be based on which of the
ff conditions
A. the surrogate is a family member and has recently lived with the pt
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