Seneca College; PNR/ PNR 300 Final Exam Solutions

2.Jeffrey is a 60 year old who had knee surgery 1 day ago. Ashley the night nurse informs Jalpa the day nurse that Jeffrey received one dose of morphine 2 hours ago and has been sleeping since then with no pain. Jalpa assesses Jeffrey and finds he has no vital signs, a Code Blue is called and Jeffrey is declared deceased. On chart review Ashley did not assess Jeffrey at any time after giving morphine, hospital policy dictated vital signs should be assessed every 15 mins for one hour after giving morphine. Ashley's failure to properly monitor Jeffrey is an example of what: Assault Intentional Tort Negligence Incapacity 3.Documentation is used to communicate to all members of the health care team and to monitor client status and progress. All of the following are examples how nurses demonstrate this standard except? Ensuring timely, complete and accurate record of care provided Documenting both objective and subjective data accurately Using abbreviations appropriately Ensuring documentation is made in a temporary format or record 4. Riley, a 12-year-old boy with leukemia, has been undergoing treatment for the last two years. When asked about his disease, Riley is able to articulate the details of his illness and treatment. For the last six months, Riley's condition has deteriorated, and he has been admitted to the hospital several times. Riley has expressed desire to discontinue his treatment and says "I know if I don't have my treatment, I won't live anymore". According to the Health Care Consent Act: Riley is a minor and cannot consent to withdrawing treatment Riley is only 12-years-old and is not capable of making an informed and voluntary decision Riley appreciates his illness and its consequences and is considered capable of making the decision to withdraw treatment. Riley can withdraw treatment if his parents agree with the decision 5.Monique an RPN has worked in a labour and delivery unit for 20 years. When resolving ethical situations, Monique does not think she needs to consult with her colleagues because they do not have as much experience as she does. Monique insists and is adamant on demonstrating bathing of an infant to the baby's father, because she feels it is beneficial for fathers to be actively involved. This has been raised as an ethical issue on the unit by newer staff. What should the team do in this situation? Regardless of experience or expertise, consulting about ethical situations helps support decision-making Monique's experience is enough, and she is able to resolve ethical conflicts independently Monique is correct. Parents often experience anxiety over a new baby Monique should be removed from being a client's primary nurse whenever their values do not match S - The Marketplace to Buy and Sell your Study Material Downloaded by: britneybrits19 | Distribution of this document is illegal Want to earn $103 per month? contact: S - The Marketplace to Buy and Sell your Study Material 6.A Nurse witnesses a nursing colleague hitting a client. The nurse intervenes and stops the abuse. The nurse identified that she was tired and frustrated, and that it will never happen again. She asked the witness not to tell the manager. What is the witness's responsibility in this situation? You are responsible for supporting your colleague who is suffering from nurse fatigue. You are responsible for protecting the client and must report the incident to the manager You are responsible for helping your colleague manage challenging patients who cause all nurses to be frustrated You can be silent because this is the first incident and the nurse said she will deal with her fatigue You are responsible for supporting your client only 7. The nurse is aware that an ethics committee in a health care facility serves to: Interview all persons involved in an ethical dilemma Illustrate circumstances that demonstrate malpractice Serve as a resource for specific situations as they occur Examine previous similar cases for comparison of outcome decisions 8.Your client who has dementia refuses his 0800 medications. His daughter is his substitute decision-maker. What should the nurse do? Crush the medications, put them in apple sauce and then feed it to him Contact his daughter to discuss the change in behavior Get someone to help you open his mouth and make sure he swallows the medications Contact his daughter and insist she come to the home and make sure her father takes his medications 9.Alyssa is a client on a mental health unit. On admission, she is a voluntary client and is competent to make treatment decisions. She is diagnosed with an eating disorder. At meal times, she is anxious and only eats fruit with ice cream. Her nurses want to give her a prn (take as needed) medication to reduce her anxiety in order that she will eat more food. Alyssa is undernourished and has lost weight. Identify the correct statement about Alyssa's situation A voluntary patient lacks capacity to make treatment decisions A patient with incapacity is not able to understand the information relevant to making a decision about the proposed treatment A patient with capacity is able to understand the information relevant to making a decision about the proposed treatment A person capable of making treatment decisions never needs to be an involuntary patient 10.Joanne is a RPN on a surgical unit. She has noticed that when she works with RPN Kerri that the narcotic count is not accurate and Kerri often has slurred speech and an unsteady gait. Joanne suspects that Kerri is abusing substances. According to the CNA Fact Sheet on problematic substance abuse by nurses, the most important reason that Joanne needs to address her colleague's behaviour is: To ensure there are no potential negative effects on patient care Downloaded by: britneybrits19 | Distribution of this document is illegal Want to earn $103 per month? S - The Marketplace to Buy and Sell your Study Material To ensure Kerri receives appropriate counselling To report the behaviour to the nurse manager and the police To report the behaviour to the CNO 11.Barbara an RPN has been found guilty of a criminal offense. She physically assaulted Rafael an RPN in the hospital parking lot. She was sentenced to prison for six months. In accordance with the regulation under the provincial nursing act what must she do? She can work as a nurse while she is in prison, and then reapply for her job once she gets out Provide the College of Nurses with details and findings of the court case. They will determine a back to work plan when she is released She does not need to report any information to the College of Nurses as this did not involve a patient or her role as a nurse Recommend that her lawyer began an appeal so that it does not affect her license 12.Sandra is an RPN in a busy downtown emergency department which has been chronically short staffed. Sandra has been asked to stay past her shift for another 8 hours because of 2 last minute sick calls. She is feeling very tired as this is her 4th shift in a row and her second overtime shift this week. Despite feeling pressure to take the shift, Sandra refuses the extra hours, explaining to her manager that she is too tired and is aware that fatigue can have a very negative impact on patient care. She also advocates that the manager start to implement some work life strategies in the ED to help make the ED a safe work environment for staff. This is an example of which of the following: Macro level of influence Micro level of influence Meso level of influence Patient abandonment 13.Mr. Patel is a 40 year old male who requires a below the knee amputation of the left leg as a result of severe ulcers and gangrene. He refuses to have the operation. After the physician explains to him the purpose for the surgery, the risks, benefits and outcomes of the surgery and answers questions that he has, Mr. Patel continues to refuse to have surgery. His family says he is irrational and incompetent and his wishes must be overruled. They want him to have the surgery. If the health care team tells Mr. Patel that he must agree to the surgery or else they will have him labeled as incompetent, their action is an example of: Coercion of Mr. Patel Following hospital protocol Looking out for his own best interests Making sure Mr. Patel knows the consequences of his decision 14.What is nursing fatigue primarily caused by? Environmental factors Nurses' inability to sleep during the day Nursing shortage Heavy workloads All of the above Downloaded by: britneybrits19 | Distribution of this document is illegal Want to earn $103 per month? S - The Marketplace to Buy and Sell your Study Material 15.According to the CNO, a nurse is guilty of patient abuse especially neglect when s/he: Tells a teenage patient to "grow up" Does not answer a call bell because the patient rings frequently Forgets to give patient medications at the correct time Does not chart on a patient after a busy shift 16. Obtaining informed surgical consent is the responsibility of: The physician The nurse manager The nurse (RN or RPN) The unit secretary 17.Identify the correct statement regarding restraint use in mental health facilities. The least restraint policy does not apply Restraints are proven to reduce difficult behaviours Restraints do not need a doctor's order; only if using medications Most injuries to staff occur when clients are in some type of restraint