1. The nurse and the student nurse are caring for two different patients on the medical-surgical unit. One patient is in airborne precautions, and one is in contact
precautions. The nurse explains to the student different interventions for care. Which information will the nurse include in the te...
ATI PN LEADERSHIP MANAGEMENT PROCTORED EXAM COMPLETE SOLUTION 2023 (Detail Solutions) 1. The nurse and the student nurse are caring for two different patients on the medical -surgical unit. One patient is in airborne precautions, and one is in contact precautions. The nurse explains to the student different interventions for care. Which information will the nurse include in the teaching session? ( Select all that apply. ) a. Dispose of supplies to prevent the spread of microorganisms. b. Wash hands before entering and leaving both of the patients’ rooms. Be consistent in nursing interventions since there is only one c. difference in the precautions. Apply the knowledge the nurse has of the disease process to prevent d. the spread of microorganisms. Have patients in airborne precautions wear a mask during e. transportation to other departments. Check the working order of the negative -pressure room for the f. airborne precaution patient on admission and at discharge. ANS: A, B, D, E Washing hands, properly disposing of supplies, applying knowledge of the disease process, and having patients in airborne precautions wear a mask during transfer are all principles to follow when caring for patients in isolation. Multiple differences are evident among these types of isolation, including the type of room used for the patient and what the nurse wears while caring for the patient. It is important to check the working order of a negative -pressure room before admitting a patient to the room, each shift the patient is in the room, and if and when the device alarms. Checking the working order of the negative -pressure rooms at discharge is not necessary. MULTIPLE CHOICE 1. A nurse is caring for a 15-year-old who in the past 6 months has had multiple male and female sexual partners. Which response by the nurse will be most effective? 56 “Sexually transmitted infections and unwanted pregnancy are a real risk. Let’s discuss what you think is the best method for protectingyourself.” “Having sexual interaction with both males and females places you at higher risk for STIs. To protect yourself, you need to decide whichorientation you are.” “Your current friends are leading you to make poor choices. You a. should find new friends to hang out with.” “I think it’s best to notify your parents. They know what’s best for you b. and can help make sure you practice safe sex.” ANS: A Some adolescents participate in risky behaviors. The nurse should acknowledge this feeling to the patient and off er education and alternatives, while giving the patient the autonomy to make his or her own decisions. Adolescents who engage in sexual risk behaviors experience negative health outcomes such as STIs and unintended pregnancy. In addition, the pattern of risk- taking behavior tends to be established and continue throughout life. The nurse should not force the patient to make a choice of orientation and should not pass judgment on a patient’s sexual orientation or social network; this would make the patient feel defensive and would eliminate the trust in the relationship. Involving parents is not the first line of action; parents should be notified only if the child is in a life or death situation. 2. A nurse is caring for a patient who expresses a desire to have an elective abortion. The nurse’s religious and ethical values are strongly opposed. How should the nurse best handle the situation? a. Attempt to educate the patient about the consequences of abortion. Refer the patient to a family planning center or another health b. professional. Continue to care for the patient, and limit conversation as much as c. possible. 57 Inform the patient that, because of immoral issues, another nurse will d. have to care for her. ANS: B The nurse must be aware of personal beliefs and values and is not required to participate in counseling or procedures that compromise those values. However, the patient is entitled to nonjudgmental care and should be referred to someone who can create a trusting env ironment. The nurse should not care for a patient if the quality of care could be jeopardized. The nurse should not attempt to push personal values onto a patient. The nurse also should not create tension by informing the patient that he or she does not ha ve the same morals; this could cause the patient to feel guilty or defensive when receiving care from any health care professional. 3. Which patient is most in need of a nurse’s referral to adoption services? a. A woman considering abortion for an unwanted pregnancy b. An infertile couple religiously opposed to artificial insemination c. A woman who suffered miscarriage during her first pregnancy d. An infertile couple who has been attempting conception for 3 months ANS: B Adoption is an option for someone with infertility, especially if infertility treatments are unavailable owing to religious or financial constraints. A patient who wishes to have an elective abortion may be educated about all the possibilities, but the nurse should approach the patient in a nonjudgmental manner and should accept the patient’s decision. When a patient has recently miscarried, the nurse should assess the patient’s feelings about the loss and should address any concer ns the patient may have about fertility. Infertility is the inability to conceive after 1 year of unprotected intercourse; therefore, talking about adoption after one miscarriage or after only 3 months of attempting conception would be too soon. 4. The nurse is caring for a patient who recently had unprotected sex with a partner who has HIV. Which response by the nurse is best? “You should have your blood drawn today to see if you were a. infected.” b. “If you have the virus, you will have 58 flu-like symptoms in 6 months.” “Highly active antiretroviral therapy has been shown effective in c. slowing the disease process.” “I will set you up with a support group to help you cope with dying d. within the next 10 years.” ANS: C Highly active retroviral therapy increases the survival time of a person with HIV or AIDS. HIV antibodies will not show up in blood work for 6 weeks to 3 months. The infection stage of HIV lasts for about a month after the virus is contracted; during that time, the patient may experience flu -like symptoms. A support group may be beneficial for a patient who contracts HIV; however, it is unknown whether the patient has contracted HIV, and antiretroviral therapy has helped people live beyond the 10 years expected if HIV goes untreated. 5. An 18-year-old male patient informs the nurse that he isn’t sure if he is homosexual because he is attracted to both genders. Which response by the nurse will help establish a trusting relationship? a. “Don’t worry. It’s just a phase you will grow out of.” b. “Those are abnormal impulses. You should seek therapy.” c. “At your age, it is normal to be curious about both genders.” “Having questions about sexuality is normal but if these sexual d. activities make you feel bad you should stop.” ANS: C Adolescents have questions about sexuality. The patient will feel most comfortable discussing his sexual concerns further if the nurse establishes that it is normal to ask questions about sexuality. The nurse can then discuss in greater detail. Although it is normal for young adults to be curious about sexuality, the nurse should use caution in giving advice on taking sexual action. The nurse should promote safe sex practices. Telling the patient not to worry dismisses his concern. Telling the patient that he is abnormal might offend the patient and prevent him from establishing an open relationship. 59 6. A nurse is caring for a 35-year-old female patient who recently started
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