A nurse is teaching a class on torts.
The nurse should include which of the following situations as an example of negligence?
A client who is competent refuses an antidepressant medication. The nurse dissolves the medication in food and administers it to her without her knowledge.
A client who is alert and oriented makes an informed decision to leave the hospital against medical advice. The nurse applies restraints to the client to prevent him from leaving.
A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client that she will apply wrist restraints if he does not stop eating the salted potato chips.
A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.
The Correct Answer is D
Choice A rationale
Administering medication without a competent client's knowledge or consent constitutes battery, an intentional tort. Battery involves an unconsented touching of another person, even if the intent is benevolent. This action violates the client's autonomy and right to self-determination regarding their medical treatment, which is a fundamental ethical and legal principle in healthcare.
Choice B rationale
Applying restraints to a competent, alert, and oriented client who wishes to leave against medical advice is false imprisonment, an intentional tort. False imprisonment involves the unlawful restraint of a person against their will. Competent adults have the right to refuse treatment and discharge themselves, and their freedom of movement cannot be unduly restricted.
Choice C rationale
Threatening to apply restraints to a client for not adhering to a dietary restriction constitutes assault, an intentional tort. Assault involves placing another person in reasonable apprehension of an immediate harmful or offensive contact. While dietary adherence is important, threatening physical restraint for non-compliance is an inappropriate and unlawful response.
Choice D rationale
This scenario exemplifies negligence, which is unintentional tort. Negligence occurs when a healthcare professional fails to act as a reasonably prudent nurse would under similar circumstances, resulting in harm to the patient. The delay in reporting a critical change in a client's condition, such as absent peripheral pulsation, falls below the standard of care and can lead to severe and irreversible tissue damage or limb loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Applying a fetal scalp electrode is an invasive procedure that provides a more accurate assessment of fetal heart rate. However, late decelerations indicate uteroplacental insufficiency requiring immediate interventions to improve fetal oxygenation before considering invasive monitoring.
Choice B rationale
Performing a vaginal exam can assess labor progress and rule out cord prolapse or other issues. While important, it is not the immediate priority when late decelerations indicate acute fetal hypoxemia; improving oxygenation to the fetus is paramount.
Choice C rationale
Inserting an intravenous catheter is essential for administering fluids or medications. However, the most immediate intervention for late decelerations is to improve uterine blood flow and fetal oxygenation, which is achieved through maternal repositioning as the first step.
Choice D rationale
Late decelerations indicate uteroplacental insufficiency, meaning reduced blood flow and oxygen to the fetus. Repositioning the client to the left-lateral position relieves pressure on the vena cava, improving venous return to the heart, thus increasing uterine blood flow and fetal oxygenation by optimizing placental perfusion.
Correct Answer is A
Explanation
Choice A rationale
Hypertension is a major modifiable risk factor for the progression of polycystic kidney disease (PKD) to end-stage renal disease (ESRD). Uncontrolled blood pressure exacerbates glomerular damage and accelerates the decline in renal function. Effective blood pressure control, often targeting specific parameters, significantly reduces the strain on kidneys, preserving nephron function and delaying ESRD.
Choice B rationale
While blood glucose control is crucial for clients with diabetes to prevent diabetic nephropathy, it is not the primary or most important intervention for slowing the progression of polycystic kidney disease (PKD). PKD is an inherited disorder characterized by cyst formation, and its progression is mainly driven by factors like hypertension.
Choice C rationale
Fluid restriction is generally not a primary intervention for slowing the progression of polycystic kidney disease (PKD). In fact, maintaining adequate hydration is often encouraged to prevent dehydration and reduce the risk of kidney stone formation, which can be a complication in PKD. Fluid management is individualized based on kidney function.
Choice D rationale
Pain management is important for comfort in clients with polycystic kidney disease (PKD) dueating to cyst enlargement or complications. However, managing pain does not directly slow the progression of the underlying disease process to end-stage renal disease (ESRD). The primary focus for slowing progression is on managing factors that directly impact renal function.
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