Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who has a tumor. The provider recommends surgery. The client refuses, but the client's partner wants the surgery performed. Which of the following is the deciding factor in determining if the surgery will be done?
A. Whether the client's refusal is based on religious belief
While religious beliefs may influence a client's decision, they are not the deciding factor. Clients have the right to refuse treatment regardless of the reason, as long as they are competent and informed.
B. Whether the partner is the client's durable power of attorney for health care
The partner’s role as the durable power of attorney for health care is only relevant if the client is unable to make decisions due to incompetence or incapacitation. If the client is competent, their decision takes precedence over the wishes of their partner or any legal proxy.
C. Whether the client understands the risk of refusing the procedure
Ensuring the client understands the risks of refusing the procedure is the deciding factor. A competent client has the right to refuse any medical treatment, including surgery, after being informed of the potential consequences. The nurse and provider must ensure the client’s decision is informed and voluntary.
D. Whether the facility ethics committee reaches a consensus on the case
The facility ethics committee may provide guidance in complex cases, but they do not override a competent client’s autonomy. The client’s informed decision is the ultimate determinant in whether the surgery is performed.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Rn Leadership 2019 Proctored Exam. Take the full exam now
Full Explanation
A. While religious beliefs may influence a client's decision, they are not the deciding factor. Clients have the right to refuse treatment regardless of the reason, as long as they are competent and informed.
B. The partner’s role as the durable power of attorney for health care is only relevant if the client is unable to make decisions due to incompetence or incapacitation. If the client is competent, their decision takes precedence over the wishes of their partner or any legal proxy.
C. Ensuring the client understands the risks of refusing the procedure is the deciding factor. A competent client has the right to refuse any medical treatment, including surgery, after being informed of the potential consequences. The nurse and provider must ensure the client’s decision is informed and voluntary.
D. The facility ethics committee may provide guidance in complex cases, but they do not override a competent client’s autonomy. The client’s informed decision is the ultimate determinant in whether the surgery is performed.
Similar Questions
A nurse is teaching a newly licensed nurse about implementing droplet precautions for a client who has influenza. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
A. "I will wear an N95 respirator when providing care for the client."
While an N95 respirator might be used for airborne precautions, for droplet precautions, a surgical mask is sufficient.
B. "I will check that the room has a high-efficiency particulate air filtration system."
While an air filtration system might be beneficial for infection control, it is not a specific requirement for implementing droplet precautions.
C. "I will wear a surgical mask within 3 feet of the client."
Wearing a surgical mask within a close proximity (around 3 feet) of the client aligns with the guidelines for droplet precautions.
D. "I will assign the client to a room with positive airflow."
Assigning the client to a room with positive airflow is not necessary for implementing droplet precautions, which focus on preventing transmission through respiratory droplets.
E. "I will assign the client to a room with positive airflow."
Full Explanation
A. While an N95 respirator might be used for airborne precautions, for droplet precautions, a surgical mask is sufficient.
B. While an air filtration system might be beneficial for infection control, it is not a specific requirement for implementing droplet precautions.
C. Wearing a surgical mask within a close proximity (around 3 feet) of the client aligns with the guidelines for droplet precautions.
D. Assigning the client to a room with positive airflow is not necessary for implementing droplet precautions, which focus on preventing transmission through respiratory droplets.
A nurse working on a medical-surgical unit is managing the care of four clients. The nurse should schedule an interdisciplinary conference for which of the following clients?
A. A client who has Type 1 diabetes and uses an insulin pump
A client with Type 1 diabetes using an insulin pump requires ongoing coordination between nursing, endocrinology, pharmacy, and potentially nutrition services. Management involves insulin dosing adjustments, blood glucose monitoring strategies, device education, and lifestyle planning, making interdisciplinary collaboration essential.
B. A client who is at risk for pressure ulcers and has an albumin level of 4.2 g/dl
An albumin level of 4.2 g/dL is normal, indicating adequate nutritional status. A pressure injury risk alone without additional complications does not require an interdisciplinary conference.
C. A client who is receiving heparin and has an aPTT of 34 seconds
An aPTT of 34 seconds is within or near normal range depending on reference values, so there is no indication of urgent anticoagulation management requiring team coordination.
D. A client who has orthostatic hypotension and is receiving IV fluids
Orthostatic hypotension managed with IV fluids is typically addressed through routine medical and nursing management unless it becomes refractory or complicated, so it does not require a formal interdisciplinary conference.
Full Explanation
A. A client with Type 1 diabetes using an insulin pump requires ongoing coordination between nursing, endocrinology, pharmacy, and potentially nutrition services. Management involves insulin dosing adjustments, blood glucose monitoring strategies, device education, and lifestyle planning, making interdisciplinary collaboration essential.
B. An albumin level of 4.2 g/dL is normal, indicating adequate nutritional status. A pressure injury risk alone without additional complications does not require an interdisciplinary conference.
C. An aPTT of 34 seconds is within or near normal range depending on reference values, so there is no indication of urgent anticoagulation management requiring team coordination.
D. Orthostatic hypotension managed with IV fluids is typically addressed through routine medical and nursing management unless it becomes refractory or complicated, so it does not require a formal interdisciplinary conference.
A charge nurse witnesses an assistive personnel (AP) failing to follow facility protocol when discarding contaminated linens. Which of the following actions should the nurse take first?
A. Notify the unit manager about the incident.
B. Alert the infection control department.
C. Discuss the issue with the AP.
D. Reinforce facility protocols at the next staff meeting.
Full Explanation
A. Notifying the unit manager should happen but discussing the issue with the AP directly is the initial step in addressing the problem.
B. Alerting the infection control department is important, but direct communication with the AP should come first to address the immediate concern.
C. Speaking with the AP allows for immediate clarification and correction of the behavior, aiming to prevent further incidents.
D. Reinforcing facility protocols at a staff meeting is beneficial, but immediate correction at the individual level is more crucial to prevent recurrence of the issue.