Patient Advocacy: Advocacy NCLEX Style Exam .
Advocacy NCLEX Style Exam . Which of the following is the best example of a situation where a nurse could demonstrate workforce advocacy? A. A client wishes to become an organ donor in spite of family opposition. B. A client feels pressured by a health care provider into agreeing to a specific medical procedure. C. A nurse volunteers time to participate in a fund raiser to provide toys for a hospital's pediatric unit. D. Staff on a particular unit feel that the nurse manager is showing favoritism when granting vacation time. - B Nurses' strong concern and commitment to patient care and their role as patient advocates often place them in direct conflict with those who have more control, such as physicians and health care administrators. How a nurse reacts to such conflicts within the workplace and continues to advocate to improve patient care is a necessary focus for the profession—a focus called workforce advocacy. Volunteering time to provide funds for toys shows an interest in the client's welfare but is not as strongly related to client care. Advocacy for a client wishing to become an organ donor is an example of patient advocacy. The issue of fair management in this situation does not involve client care. Based on current trends, which nursing care environment has the greatest employment potential for new nurses? A. Long-term care facilities B. Hospital emergency departments C. Pre- and postsurgical departments D. Primary health care provider practices - A Employment will not grow at the same rate in every setting—hospital employment will grow more slowly because many procedures and care are shifting to outpatient and home health settings, more sophisticated procedures can safely be done outside the hospital, and home health and long-term care facilities will see employment growth due to the aging population. The other options are more traditional environments and so are not as likely to show increased employment growth. In order to best address workplace satisfaction among its nursing staff, a hospital's administration provides: A. a yearly salary raise. B. tuition reimbursement. C. additional vacation time. D. an extra 15-minute break per shift. - B Areas that have been identified as affecting nursing satisfaction include: 1) opportunities to influence decisions about workplace organization; 2) recognition of accomplishments and work well done; 3) opportunities for professional development and advancement; and 4) opportunities to influence decisions about patient care. Tuition reimbursement would meet the interest in professional development of many nurses. Although the other options are considered favorable gestures, they do not address the identified factors. Which hospital-wide policy would best address the nurse's negative view of job satisfaction? A. Making it possible to earn additional personal leave time based on their absentee records B. Providing a dedicated parking area close to the hospital for nursing staff C. Instituting biannual staff recognition days that include a free meal in the cafeteria D. Providing security backup when there is a perceived sense of workplace violence - A RNs are generally satisfied with their jobs when hospital administrators emphasize quality of patient care; recognize the importance of their personal and family lives; and provide nurses with satisfying salary and benefits, high job security, and positive relationships with other nurses and with management. The other policies may appeal to groups of nurses, but they are not directed towards any of the major job satisfaction indicators. In order to best ensure client safety, which of the following questions should a staff nurse ask first when determining whether to accept a client assignment that is made when several staff members have reported off sick? A. "Do I have the experience and knowledge to care for these patients?" B. "Is this a staffing crisis or a result of typical staffing patterns?" C. "Can I expect to be mandated to stay an additional shift?" D. "How long will it be before I get additional help?" - A Although all these questions can help the staff nurse think critically about accepting the assignment, initially the important question is whether the nurse possesses the experience, skills, and knowledge necessary to safely provide appropriate care for the clients she is asked to care for. Your adult patient is scheduled for an x-ray film of the head. He is refusing to go, despite the fact that the x-ray film will give vital information related to his chief complaint of a headache. The nurse learns of the patient's refusal and comes in to the patient's room saying, "If you don't go to this x-ray, I'll have to give you a shot to put you out." In your opinion, has the nurse committed a legal mistake? A. No, the nurse is acting in the best interests of the patient who needs the test to treat him. B. No, the nurse is merely trying to help the patient understand the necessity of cooperating with the ordered treatment regimen. C. Yes, the nurse may have committed an assault on the patient by verbally threatening him. D. Yes, the nurse may have committed malpractice by forcing the patient to do something against his will. - C An assault is any verbal or nonverbal threat that places the recipient in reasonable fear of imminent danger. Stating that the nurse will give the patient an injection to make him comply with a treatment is a verbal threat. If the patient is reasonably afraid of getting the x-ray film and the injection to sedate him if he continues to refuse, he may have a reasonable fear of imminent harm or danger. Although the x-ray film may be beneficial to the patient, the patient is an adult with apparent sufficient capacity to refuse a treatment. Therefore an argument related to his "best interest" has no relevance to his refusal. The issue of malpractice does not exist unless and until the nurse follows through on the threat, at which point the nurse will have breached her duty to the patient to respect his right to self-determination/autonomy. A nurse has received a letter from the State Board of Nursing in which he practices that he has been placed on probation and that his license is suspended. The nurse has received no other information about this action. What, if any, claims does this nurse have? A. The nurse has a claim against the State Board of Nursing for a violation of his right to privacy. B. The nurse has a claim against the State Board of Nursing for violating his rights to due process. C. The nurse has a claim against the hospital where he works for failing to represent him in a civil law suit. D. The nurse has no claim against the State Board of Nursing and the hospital. - B The nurse has a claim against the State Board of Nursing. He has a right of due process, which includes the right to timely and sufficient notice of the charges against him. He has a right to a hearing regarding the charge, the right to review evidence against him or her, and the right to question those who bring evidence against him. There is no violation of the nurse's privacy in the current fact pattern. The nurse's hospital may or may not be required to represent the nurse, depending on the nature of the charge and whether it related to the scope of the nurse's employment. A patient's daughter is speaking to the nurse caring for her father. The daughter has presented the nurse with a document identifying her as the spokesperson for the patient when he is no longer capable of speaking for himself. Which of the following best characterizes the daughter's legal relationship with her ailing father? A. Health care proxy B. Legal Samaritan C. Guardian ad litem D. Attorney - A The health care proxy is a surrogate decision maker chosen by the patient and documented in a legal form dated and signed by the patient and notarized by an impartial notary (in many states). Formally this document is known as a durable power of attorney for health care. There is no such characterization known as a legal Samaritan. A guardian ad litem is a person chosen by a court of law with written documentation describing the guardian status. A guardian ad litem is not limited to health care decisions. An attorney may or may not be a health care proxy. A health care proxy does not have to be an attorney. A patient is discussing her surgery with her surgeon. The physician leaves and asks you to have the patient sign the consent form in a few hours. Which statement made by the patient indicates that informed consent has likely been achieved? A. The patient states that the doctor has told her there is nothing more they can do and she is going home. B. The patient states that she has not spoken with her surgeon at all today. C. The patient states that her surgeon has told her that she doesn't need surgery. D. The patient states that she is having surgery on her leg in the morning and that she will have some pain and bleeding for a few days. - D By stating that she is having surgery in the morning and that she understands some pain and bleeding will occur, the patient reflects a reasonable understanding about the plan for her surgery and the likely outcomes. Stating the doctor has nothing more to do so she is being released, stating that her surgeon indicated surgery is not necessary, and stating that she hasn't spoken to her surgeon all day indicate that the patient may be in denial and needs further explanation, instruction, and support before undergoing surgery. A nurse believes that a pediatric patient has been the victim of abuse based on verbal statements and scarring noted on the patient's abdomen and legs. Which of the following is the best action for the nurse to take? A. Do nothing but document the patient's condition. B. Contact the patient's family. C. Contact the patient's teacher. D. Contact the Child Abuse Hotline. - D Nurses are mandatory reporters for suspected child abuse. Although documenting the patient's condition is important, it is insufficient to meet the mandatory reporting requirement. Contacting the patient's teacher and/or family does not meet the mandatory reporting requirement. A health care provider has written an order for a patient to receive a medication every 6 hours for 7 days. You note that the patient has indicated that she is allergic to this medication (rash, shortness of breath). Which of the following should you do first? A. Contact the health care provider. B. Contact the pharmacist. C. Place a "hold" note on the medication administration record (MAR). D. Contact the nursing supervisor. - C You must stop any possible administration of the medication that will cause an allergic response in the patient. Placing a hold order on the MAR stops anyone from inadvertently administering the medication. You should then contact the pharmacy and the health care provider. The nursing supervisor should be contacted if the health care provider does not act to rescind the order. A patient's visitor has fallen in the patient's room. Which of the following is the most appropriate action for the nurse to take? A. Call the nursing supervisor. B. Assist the visitor and document with an occurrence report. C. Assist the visitor and, if there is no injury, document nothing. D. Assist the visitor and document the occurrence in the patient's chart. - B The nurse's first action would be to assist the visitor to make sure that he or she is safe and then complete an occurrence report. An occurrence report is completed for any unanticipated event, whether it occurs to a patient or visitor. It is completed even though there is no apparent injury. An occurrence report is never referred to in the patient's chart. Calling the nursing supervisor is a proper action but only after the visitor has been made safe and the occurrence documented in an appropriate form. Although you normally work in a hospital setting, you have volunteered at a homeless shelter at a blood pressure clinic. If an incident occurs at the blood pressure clinic, what is your most likely liability protection provider? A. Your employer hospital malpractice insurance B. Your home insurance C. Your professional liability insurance D. No one (There is a small likelihood that a nurse will be sued in this type of situation.) - C Your employer is only obligated to defend your actions as an agent of the employer when you are working within the scope of your employment. Your home insurance does not cover your actions in this situation unless you also have professional liability attached to your homeowner's policy. You are the night shift nurse for a hospital nursing division of 40 acutely ill postoperative patients. The staffing for the night shift is you plus two patient care technicians. Based on the end-of-shift report, the current staffing, and your assessment of the patients, you have determined that there is insufficient staff to safely take care of the patients on this nursing division. What is the best action for you to take? A. Leave the nursing division immediately and go home. B. Contact the nursing supervisor, inform him or her of the situation, and leave the nursing division. C. Contact the chief of medicine and inform her or him of the situation and document it. D. Contact the nursing supervisor, inform him or her of the situation, and document it. - D Leaving the nursing division, even with documentation and notice of the situation to your nursing supervisor, may be seen as patient abandonment. Contacting the chief of medicine is insufficient notice to the nursing employer of the unsafe situation. One of the elements of professional negligence is the failure to act according to the standard of care or breach of duty. Standard of care may best be defined as which of the following? (Select all that apply.) A. Nursing competence as defined by the State Nurse Practice Act B. Giving nursing care in the most expedient and timely way possible C. The degree of nursing judgment and skill given by a reasonably prudent nurse under similar circumstances D. Providing health services according to community expectations and ordinances - A, C, D Duty under any standard of care is the degree of nursing judgment and skill given by a reasonably prudent professional in the same or similar circumstance. A standard of care is defined by the State Board of Nursing Practice Act and current community standards. Expedient care, although timely, may not necessarily meet the standard of care. You are caring for a patient who will undergo a bone marrow aspiration, a difficult and painful procedure necessary to monitor the progress of recuperation after bone marrow transplantation. You are eager to minimize pain for this patient. You review the medical record for previous successful pain-management plans. You discuss the procedure with the patient. You advocate for the patient when the health care provider arrives to prepare for the procedure. Which ethical principle best describes the reasons for your actions? A. Beneficence B. Accountability C. Nonmaleficence D. Respect for autonomy - C Although all these principles are important and valuable for nursing practice, the principle of nonmaleficence best describes efforts to minimize pain, particularly when at least some pain is unavoidable. The term is Latin and translates literally as "non" indicating "not" and "maleficence" indicating "harmful act." According to annual assessments performed by the Federal Government, certain groups of people in the United States have poor or no access to health care. You decide to write an editorial to your local newspaper expressing your opinion about this situation. Which ethical principle would you incorporate into your editorial? A. Accountability because as the nurse you are accountable for the well-being of all patient groups B. Respect for autonomy because autonomy is violated if care is not accessible C. Ethics of care because the caring action would be to provide resource access for all D. Justice since this concept addresses questions about the fair distribution of health care resources - D Accountability, respect for autonomy, and ethics of care are valuable and could be incorporated into a discussion about access, but the fundamental principle that shapes thinking about access to care is the principle of justice. You have agreed to serve on a Policy and Procedure committee at your hospital, representing the voice of bedside nurses from your unit. The committee is discussing a revision to the staffing ratio policy at your hospital by discussing these questions: How many patients can a nurse safely and effectively care for on your unit? Does the ANA professional code of ethics support your concerns about staffing ratios? Indicate the best answer. A. No, the code describes philosophical principles that are important to ethical discourse but unrelated to staffing ratios. B. Yes, the code supports nurses' participation in conditions of employment, including the promotion of quality health care using both individual and collective action. C. No, to support staffing ratio discussions the ANA publishes journals containing research about best practices in a variety of health care settings D. No, the code is not necessary for this discussion since historical foundations of nursing as defined by Florence Nightingale established staffing ratios before the ANA code of ethics. - B The code of ethics clearly and convincingly establishes guidelines to shape nursing practice by promoting ethical behaviors, including the promotion of nursing involvement in issues that shape nursing practice beyond individual behaviors. Utilitarianism is a term commonly found in ethical discourse, but it stands for only one of several different approaches to ethical discourse. Which is a true statement about the ethical philosophy of utilitarianism? A. The value of an intervention is determined primarily by its usefulness to society. B. The value of an intervention is culturally established based on predetermined measures. C. The decision to provide medical care depends on a measure of the moral life of the patient. D. Attention to relationships provides resolution to ethical dilemmas. - A Utilitarianism is based on the notion of "usefulness." "The value of an intervention is culturally established based on predetermined measures" and "Attention to relationships provides resolution to ethical dilemmas" describe other philosophical approaches to ethical discourse but not utilitarianism. "The decision to provide medical care depends on a measure of the moral life of the patient" is a false statement. Ethical dilemmas often arise over a conflict of opinions. Each of the following steps constitutes a correct step to take toward resolution of an ethical dilemma. What order should these steps be taken? 1. Clarify your own values about the issue. 2. Call a meeting in which those involved in the dilemma can discuss (negotiate) the possible solutions to the dilemma. 3. State the problem clearly in a way that all involved can understand. 4. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma. CONT..
Escuela, estudio y materia
- Institución
- Keiser University
- Grado
- Advocacy NCLEX
Información del documento
- Subido en
- 12 de febrero de 2023
- Número de páginas
- 38
- Escrito en
- 2022/2023
- Tipo
- OTRO
- Personaje
- Desconocido
Temas
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advocacy nclex style exam
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patient advocacy
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leadership nclex questions patient advocacy
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which of the following is the best example of a situation where a nurse could demonstrate workforce advocacy
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b
