For correct answer choice:
Proceed with surgery without informed consent is correct. In emergencies where the client cannot give consent and immediate action is necessary to save their life or prevent serious harm, the healthcare team can proceed without obtaining consent. This is by the legal principle of implied consent in emergencies.

For incorrect answer choices:
Delay the surgery until a family member arrives is incorrect. Delaying surgery can put the client at further risk, as critical conditions require timely intervention. The inability to obtain consent in an emergency does not justify postponing life-saving treatment.

Attempt to contact the client's spouse for consent is incorrect. In emergencies, obtaining consent from family members can delay necessary treatment. The law allows healthcare providers to act in the client's best interest without consent in life-threatening situations.

Request a court order to authorize the surgery is incorrect. Seeking a court order is not practical in emergencies where immediate action is required. Courts cannot provide timely decisions in such critical scenarios, and healthcare providers can proceed under the principle of implied consent.

For the correct answer choice:
Advising the client to leave the ring with a trusted friend or family member is correct. It is the safest option, as hospitals generally prefer clients to have their valuables managed by someone they trust to prevent loss or damage. This approach eliminates the risk of the item being misplaced or stolen within the hospital setting.

For incorrect answer choices:
Securing the ring in a storage bag and keeping it at the nurses' station is incorrect. The nurses' station is not a designated or secure area for storing personal valuables. There is a risk that the item could be misplaced, lost, or stolen, and nurses should avoid taking responsibility for clients' personal property.

Taping the ring to the client's finger and covering it with a bandage is incorrect. Jewellery should be completely removed prior to surgery due to the risk of interference with equipment and the potential for injury. Taping does not adequately secure the item and could still pose a safety hazard.

Having the client place the ring in a hospital-provided locker for safekeeping is incorrect. While lockers may seem secure, there is no guarantee of complete safety for valuable items, and hospitals typically advise against clients keeping valuables on-site. The responsibility for the client's valuables should remain with a trusted individual rather than the hospital.

For correct answer choice:
Accepting the assignment and performing tasks within her level of competence is correct. The nurse should acknowledge the staffing needs while ensuring she only performs tasks for which she is adequately trained, seeking help for tasks beyond her experience.

For incorrect answer choices:
Refusing to go to the intensive care unit and requesting a reassignment is incorrect. Refusal without attempting to adapt to the situation may be seen as uncooperative. The nurse should try to help while prioritizing client safety.

Contacting the nursing supervisor and demanding to work in the medical-surgical unit is incorrect. This action may not be feasible due to staffing needs, and it is more appropriate to address the situation collaboratively.

Notifying the hospital's legal team about concerns regarding the assignment is incorrect. This response is excessive for addressing the immediate issue and does not help resolve the staffing situation.

For correct answer choice:

Referring the client to a diabetes educator to provide specialized education and support is correct. This action directly addresses the client's expressed difficulties and provides access to expertise that can empower the client to manage their condition effectively. It reflects a collaborative approach to care that prioritizes the client's needs.

For incorrect answer choices:

Suggesting the client should try managing their diabetes without professional help first is incorrect. This approach may lead to poor health outcomes and does not support the client's need for guidance. The nurse should facilitate access to resources rather than leaving the client to navigate their condition independently.

Informing the client that referrals are only made by the physician is incorrect. While physicians play a critical role in the referral process, nurses are also responsible for initiating referrals and advocating for their clients. Nurses should collaborate with clients and the healthcare team to ensure timely referrals.

Waiting until the client has another appointment before discussing referral options is incorrect. Delaying the referral process may hinder the client's ability to manage their diabetes effectively. The nurse should address referral options as soon as the need is identified to promote timely intervention and support.

For correct answer choice:

Explaining the purpose, dosage, and potential side effects of each medication is correct. This information empowers the client to understand their treatment plan and recognize any adverse reactions, enhancing their ability to manage their medications safely.

For incorrect answer choices:

Informing the client to stop taking their previous medications immediately upon discharge is incorrect. Clients should receive guidance on transitioning from previous medications to new ones, as abrupt discontinuation can lead to withdrawal symptoms or worsening of their condition.

Advising clients that they do not need to worry about medication interactions as the doctor has already reviewed them is incorrect. While the doctor reviews medications, clients should still be informed about potential interactions and encouraged to ask questions, as their awareness is crucial for their safety.

Telling the client to rely on their pharmacist for all questions regarding their medications is incorrect. While pharmacists are an excellent resource, the nurse plays a vital role in educating the client about their medications during discharge. The nurse should encourage questions and provide information as part of a comprehensive discharge plan.

For the correct answer choice:
Assisting in repositioning the client every two hours is appropriate for a CNA. This task is within the CNA's scope, promoting comfort and preventing pressure ulcers.

For incorrect answer choices:
Changing the ventilator settings based on blood gas results is incorrect. This requires nursing judgment and knowledge, as it is a critical task that affects client safety.

Evaluating the effectiveness of ventilator support is incorrect. This task requires a comprehensive assessment that only a nurse can perform.

Documenting the client's sedation levels and respiratory rate is incorrect. This requires nursing assessment and decision-making skills beyond a CNA's responsibilities.

For correct answer choice:
Violation of the client's confidentiality is correct. Disclosing a client's private medical information to someone who is not authorized to receive it constitutes a breach of confidentiality.

For incorrect answer choices:
Inappropriate delegation of duties is incorrect. This term refers to assigning tasks to staff members who lack the qualifications to perform them, and not disclosing confidential information.

Lack of proper documentation is incorrect. The issue here concerns privacy, not documentation errors in the client's medical record.

Providing care without authorization is incorrect. This situation involves sharing private information, and not performing unauthorized medical procedures.

For the correct answer choice:
An 80-year-old client who alleges neglect by their in-home caregiver is correct. Situations involving potential neglect or abuse of vulnerable populations are appropriate for Ethics Committee discussions to ensure proper ethical and legal responses.

For incorrect answer choices:
A client requesting to change rooms due to noise disturbances is incorrect. This is a matter of client comfort and facility management, not an ethical issue requiring the Ethics Committee.

A young adult with diabetes who wants to decline routine lab tests is incorrect. While this involves client autonomy, it is not typically an ethical issue requiring formal committee intervention.

A nurse advocating for using additional supplies to improve client comfort is incorrect. This scenario relates to clinical practice and resource management, not ethical dilemmas needing the committee's attention.

For the correct answer choice:
Changes in the client's condition and current treatment plan is correct. This information is crucial for continuity of care, ensuring that the oncoming nurse is aware of any critical updates that may impact client safety and treatment.

For incorrect answer choices:
Personal observations about the client's behavior during the shift is incorrect. While helpful, personal observations may not provide actionable information relevant to the client's clinical care.

A summary of the outgoing nurse's interactions with the client is incorrect. Although rapport is important, this does not provide essential clinical data that the next nurse needs for effective care.

The number of visitors the client had during the shift is incorrect. While this may provide context for the client's environment, it is not essential information regarding the client’s medical condition or treatment.

For the correct answer choice:
This statement reveals that the client does not comprehend what the procedure entails, which raises concerns about informed consent. The nurse must intervene to ensure the client receives the necessary information before proceeding.

For incorrect answer choices:
Understanding that consent can be revoked shows the client is aware of their rights, which is positive.

Acknowledging awareness of possible complications indicates informed consent, making this statement appropriate.

Believing the procedure is the right choice shows confidence and Understanding of the decision, so it does not warrant intervention.

For the correct answer choice:
Inform the charge nurse of the situation and request a new assignment is correct. By notifying the charge nurse, the nurse ensures that appropriate steps are taken to maintain professional boundaries and avoid potential conflicts of interest.

For incorrect answer choices:
Continue with her duties and avoid discussing personal matters is incorrect. Despite the nurse's intention to remain professional, the neighborly relationship could still impact client care dynamics and trust.

Directly ask the client if they would prefer another nurse is incorrect. This approach may place the client in an uncomfortable position and is not an appropriate method for handling the situation.

Maintain normal care and document the relationship in the client's chart is incorrect. Documentation does not mitigate the ethical concern surrounding the personal relationship, and the nurse should seek to prevent the situation from impacting care.

For the correct answer choice:
Having the client mark an "X" on the consent form as their signature is correct. In situations where a client is unable to write, using an "X" is a legally acceptable form of signature. At least two individuals must witness it to verify that the client understood the information and voluntarily agreed to the procedure. This practice helps ensure informed consent is documented properly.

For incorrect answer choices:
Asking the healthcare provider to complete the consent process is incorrect. While the healthcare provider explains the procedure, it is the nurse's responsibility to facilitate obtaining consent and witnessing the client's mark on the form.

Obtaining verbal consent from the client without requiring a signature is incorrect. Verbal consent is not sufficient for surgical procedures; written documentation, such as marking an "X," is required to meet legal standards.

Allowing the client's spouse to sign the consent form on their behalf is incorrect. The client should give their own consent unless they are deemed legally incompetent, in which case a legally authorized representative would be required.

For correct answer choice:
A type 2 diabetes client exhibiting signs of dehydration and increased thirst is correct. These symptoms may indicate hyperglycemia or potential diabetic ketoacidosis (DKA), requiring immediate assessment and intervention to prevent serious complications.

For incorrect answer choices:
A type 1 diabetes client seeking education on managing insulin injections is incorrect. While education is vital for diabetes management, it does not require immediate assessment and can be scheduled later, especially compared to potential complications in the first option.

A type 2 diabetes client who has been experiencing mild stomach upset is incorrect. Although gastrointestinal symptoms can impact diabetes management, they are less urgent than the risk of dehydration and its associated complications.

A type 1 diabetes client presenting with a headache and elevated blood glucose readings is incorrect. Although elevated blood glucose can be concerning, the signs of dehydration and increased thirst in the first option indicate a more urgent need for intervention.

For correct answer choice:
A registered nurse directs a group of healthcare staff to provide client care is correct. The team nursing model involves an RN leading a team, which may include licensed practical nurses and nursing assistants, to deliver coordinated client care.

For incorrect answer choices:
Nursing assistants are assigned specific clients to provide total care is incorrect. Team nursing focuses on shared responsibilities rather than assigning entire client care to one staff member.

A primary nurse is responsible for all aspects of client care for one shift is incorrect. This describes the primary nursing model, not the team nursing approach.

Client care assignments are divided strictly according to tasks performed is incorrect. Although tasks may be delegated, team nursing emphasizes coordination rather than strict task division.

For the correct answer choice:
Root cause analysis is correct. It is a systematic method used in Quality Improvement to determine the underlying reasons for a problem or adverse event, allowing for the development of corrective actions to address the issue effectively.

For incorrect answer choices:
Trend prediction modeling is incorrect. This method is used to forecast future occurrences based on patterns but does not identify the specific causes behind an existing problem.

Problem impact evaluation is incorrect. While this may assess the effects of a problem, it does not seek to identify the foundational causes.

Effect monitoring analysis is incorrect. This approach tracks the results of interventions but does not provide insights into the primary causes of a problem.

For correct answer choice:
The nurse violated the law regarding client confidentiality is correct. Sharing identifiable client information on social media breaches laws such as the Health Insurance Portability and Accountability Act (HIPAA), which protects client privacy and confidentiality.

For incorrect answer choices:
The nurse displayed unprofessional conduct in their online presence is incorrect. While this statement is true, the primary legal issue lies in violating client confidentiality laws rather than merely unprofessional behavior.

The nurse failed to meet the standard of care expected in nursing practice is incorrect. Although breaching confidentiality can be viewed as a failure to uphold professional standards, the specific grounds for disciplinary action in this scenario relate more directly to legal violations.

The nurse broke a professional pledge regarding client privacy is incorrect. While nurses are expected to uphold ethical standards regarding privacy, the legal ramifications of violating confidentiality laws take precedence in matters of potential disciplinary action.

For the correct answer choice:
Relying solely on memory to recall client care needs is correct. This practice can lead to missed or forgotten tasks, jeopardizing client safety. The experienced nurse should encourage the use of lists or reminders to enhance organization and efficiency.

For incorrect answer choices:
Allocating time for routine assessments throughout the day is incorrect. This approach ensures that client evaluations are performed consistently, contributing to comprehensive care.

Maintaining open communication with team members is incorrect. This behavior fosters teamwork and improves client outcomes, as collaboration is key in nursing.

Reviewing client charts for updated care plans is incorrect. Regularly checking charts helps the nurse stay informed about changes in client conditions and care strategies, promoting better decision-making.

For correct answer choice:

Advising the client to monitor the swelling and report any changes to their healthcare provider is correct. This response promotes proactive self-management, encouraging the client to be vigilant about their symptoms and to communicate with their healthcare provider, which is essential for safe recovery.

For incorrect answer choices:

Suggesting the client reduce fluid intake significantly to address the swelling is incorrect. While fluid management can be an important part of heart failure care, drastic reductions should be guided by medical advice, as improper management can lead to complications such as dehydration or electrolyte imbalances.

Recommending that the client use over-the-counter diuretics for immediate relief is incorrect. Over-the-counter diuretics can lead to unintended side effects and should only be used under medical supervision. The nurse should not endorse self-medication without appropriate medical evaluation.

Telling the client that mild swelling is a normal part of recovery and does not require further action is incorrect. Although mild swelling can occur, dismissing it entirely may prevent the identification of potential complications. The nurse should encourage monitoring and reporting to ensure the client's safety and ongoing assessment of their condition.

For the correct answer choice:
A client who requires assistance with bathing and grooming is appropriate for a CNA. CNAs are trained to provide basic personal care and support with activities of daily living, making this assignment suitable.

For incorrect answer choices:
A client with complex medication management needs is incorrect. This requires nursing assessment and oversight, which is beyond a CNA's scope of practice.

A client exhibiting aggressive behavior due to mental health issues is incorrect. This situation requires skilled nursing intervention for safety and de-escalation techniques.

A newly admitted client with unstable vital signs is incorrect. This client needs close monitoring and assessment by a licensed nurse, which a CNA cannot provide.

For the correct answer choice:
Notifying the unit supervisor ensures that the incident is addressed promptly and professionally, following established procedures for handling staff misconduct.

For incorrect answer choices:
Delaying action may allow inappropriate behavior to continue, and addressing the issue directly with the colleague might not be effective.

The nurse does not have the authority to document incidents in personnel files; this should be done through the proper reporting channels.

Although de-escalation may help in the moment, the primary action should be to report the incident for appropriate follow-up.

For correct answer choice:

Cross-referencing the client's allergies with the medication orders to prevent adverse reactions is correct. This proactive measure enhances client safety by ensuring that the medications prescribed do not trigger allergic reactions, demonstrating the nurse's commitment to using technology to safeguard the client's well-being.

For incorrect answer choices:

Relying solely on the computer-generated alerts for potential drug interactions without further investigation is incorrect. While CPOE systems provide valuable alerts, the nurse should validate and interpret these alerts within the context of the client's overall health status and medication regimen to make informed decisions.

Noting discrepancies in the medication history but deciding to address them during the next physician visit is incorrect. Delaying action on identified discrepancies can jeopardize client safety. The nurse should communicate any medication history issues to the healthcare provider promptly to ensure appropriate interventions are taken.

Informing the client that medication orders are not available in the system and proceeding without verification is incorrect. This response fails to ensure client safety and undermines the importance of verifying medication orders. The nurse should always check the system for accurate information before proceeding with any medication administration.

For correct answer choice:

Inquiring about the client's feelings and concerns to facilitate open communication is correct. This approach demonstrates sensitivity to the client's emotional state and encourages them to share relevant information that may affect their health. Building rapport is essential for effective data collection and can lead to more accurate and comprehensive assessments.

For incorrect answer choices:

Proceeding with the assessment without addressing the client's emotional state is incorrect. Ignoring the client's emotional cues can hinder effective communication and may prevent the nurse from collecting critical data necessary for understanding the client's overall health.

Asking the client to rate their anxiety on a scale of 1 to 10 without further discussion is incorrect. While using a rating scale can be useful, it lacks depth and may not fully capture the nuances of the client's feelings. Engaging the client in a conversation about their anxiety can provide more valuable context for their condition.

Documenting the observation but not discussing it with the client is incorrect. While documentation is important, failing to address the client's emotional state during the assessment process can lead to missed opportunities for intervention and support. Engaging the client in discussion fosters a more comprehensive understanding of their needs.

For the correct answer choice:
A type 2 diabetes client who complains of dizziness and a sweet-smelling breath is correct. These symptoms suggest possible diabetic ketoacidosis (DKA), which is a life-threatening condition requiring immediate assessment and intervention.

For incorrect answer choices:
A type 1 diabetes client who reports feeling tired and is drinking a sports drink is incorrect. Although feeling tired may indicate low blood sugar, the client is already taking steps to correct the issue by consuming a carbohydrate-containing drink.

A type 1 diabetes client who needs assistance with changing a bandage on a foot wound is incorrect. While diabetic foot care is important, it does not take priority over the potential emergency of DKA.

A type 2 diabetes client who is waiting for a follow-up appointment to discuss lifestyle changes is incorrect. This client is stable and does not require immediate intervention compared to the other options.

For the correct answer choice:
A type 2 diabetes client who complains of dizziness and a sweet-smelling breath is correct. These symptoms suggest possible diabetic ketoacidosis (DKA), which is a life-threatening condition requiring immediate assessment and intervention.

For incorrect answer choices:
A type 1 diabetes client who reports feeling tired and is drinking a sports drink is incorrect. Although feeling tired may indicate low blood sugar, the client is already taking steps to correct the issue by consuming a carbohydrate-containing drink.

A type 1 diabetes client who needs assistance with changing a bandage on a foot wound is incorrect. While diabetic foot care is important, it does not take priority over the potential emergency of DKA.

A type 2 diabetes client who is waiting for a follow-up appointment to discuss lifestyle changes is incorrect. This client is stable and does not require immediate intervention compared to the other options.

For correct answer choice:
Assessment is correct. This phase involves systematically collecting data about the client's health status, including physical, psychological, and social factors. Validation of the collected data is essential to ensure its accuracy and completeness for effective nursing care.

For incorrect answer choices:
Diagnosis is incorrect. This phase involves analyzing the data collected during the assessment to identify health problems or nursing diagnoses. It is based on the information gathered but does not include the data collection process.

Planning is incorrect. In this phase, the nurse develops a care plan based on the assessment and diagnosis, setting goals and determining interventions. This phase follows data collection and is not focused on gathering information.

Evaluation is incorrect. This phase assesses the effectiveness of the nursing interventions and the client's progress toward achieving desired outcomes. It occurs after implementation and does not involve the initial data collection process.

For the correct answer choice:
Her wishes can be disregarded if family members object is correct. An Advance Directive is a legal document that reflects the individual's healthcare preferences, and these wishes must be followed regardless of family objections unless the client lacks the capacity to make decisions.

For incorrect answer choices:
She can refuse treatments that prolong her life is incorrect. An Advance Directive allows the client to refuse life-prolonging treatments, making her wishes clear.

She may appoint a trusted individual to make decisions for her is incorrect. The document typically allows the appointment of a healthcare proxy or surrogate decision-maker, ensuring her wishes are respected.

She can specify her preferences for pain management is incorrect. An Advance Directive can include specific preferences regarding pain management and other aspects of care, allowing for a more tailored approach to end-of-life treatment.

For correct answer choice:

Utilizing supplies already opened and available in the client's room before obtaining new packages is correct. This approach minimizes waste and conserves resources while still addressing the client's care needs. It exemplifies cost-effective care by efficiently using available supplies without compromising client safety or quality.

For incorrect answer choices:

Implementing a protocol to change the dressing every 12 hours to enhance healing is incorrect. While timely wound care is critical, changing dressings more frequently than prescribed may lead to unnecessary costs and can disrupt the healing process. Adhering to a clinically appropriate dressing change schedule is essential for cost-effective care.

Educating the client to order their own supplies to ensure they have enough at home is incorrect. While client education is important, directing clients to order supplies independently can lead to increased costs and potential overuse. The nurse should focus on coordinating care and managing resources effectively rather than shifting responsibility to the client.

Using sterile gloves for all dressing changes to prevent infection, regardless of the wound type is incorrect. Although infection control is paramount, using sterile gloves for every dressing change can incur unnecessary expenses. The nurse should evaluate the need for sterile gloves based on the wound's condition and follow appropriate infection control guidelines to ensure cost-effectiveness.

For the correct answer choice:
I can't share any information about the client without their permission is correct. Maintaining client confidentiality is a fundamental principle of healthcare, ensuring privacy and compliance with legal requirements like HIPAA.

For incorrect answer choices:
The client is doing fine, but you should check with the family for details is incorrect. This statement indirectly confirms the client's condition, which breaches confidentiality.

The procedure went smoothly, and the recovery is going as expected is incorrect. Providing this information without the client's consent is a violation of privacy laws.

I'm not sure, but you can speak with the client's primary nurse for an update is incorrect. Redirecting the inquiry does not comply with privacy regulations, as no client information should be shared without permission.

For correct answer choice:
Notify the unit charge nurse or supervisor is correct. The nurse is responsible for advocating for the client and ensuring their safety and dignity. Reporting the incident to a supervisor ensures that appropriate action can be taken to address the behavior and protect the client.

For incorrect answer choices:
Confront the fellow nurse in front of the client is incorrect. Addressing the issue publicly can escalate the situation and further traumatize the client. It is more effective to report the behavior to a supervisor who can handle it appropriately.

Report the incident to the hospital's ethics committee is incorrect. While ethical concerns are important, immediate action should be taken at the unit level by informing a charge nurse or supervisor, who can intervene quickly in the situation.

Ignore the situation since it is not directly related to client care is incorrect. Ignoring abusive behavior undermines client safety and trust. Nurses must report any form of abuse or misconduct to protect their clients.

For correct answer choice:

Engaging in regular audits of medication administration practices and providing feedback to the team is correct. Conducting audits is a vital component of QI efforts, as it allows the team to identify areas for improvement, monitor compliance with protocols, and enhance overall safety in medication administration.

For incorrect answer choices:

Assuming that the current medication administration practices are adequate without further investigation is incorrect. This assumption can lead to overlooking potential risks and areas for improvement. Continuous evaluation is necessary to ensure that practices remain safe and effective.

Focusing solely on improving the medication storage area rather than the administration process is incorrect. While storage is important, the primary focus of the QI project should be on the actual administration process to enhance client safety and prevent errors.

Making changes to the administration protocol independently without involving the rest of the team is incorrect. Collaboration and input from the entire team are essential when making protocol changes. Independent actions can lead to inconsistencies and undermine the effectiveness of the QI initiative.