A nurse is caring for a client who is confused and uncooperative. The client hit the nurse when she attempted to give him his medication. The nurse asks the charge nurse if she can restrain the client. The charge nurse should tell the nurse this action is a violation of the client's rights and is an example of which of the following?
Defamation of character
Slander
False imprisonment
Invasion of privacy
The Correct Answer is C
Rationale:
A. Defamation of character involves damaging someone’s reputation, which is not relevant in this context.
B. Slander involves spoken defamation, not applicable here.
C. False imprisonment refers to the unlawful restraint or restriction of an individual’s freedom, which can occur with unauthorized use of restraints.
D. Invasion of privacy involves unauthorized access to personal information or space, not directly related to the use of restraints.
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Correct Answer is B
Explanation
Rationale:
A. A client who has Guillain-Barre syndrome requires close monitoring and specialized care due to progressive weakness and potential respiratory issues. This client's care may involve more complex needs that are beyond the AP's scope.
B. A client who has a lumbosacral spinal tumor is likely to have fewer immediate needs related to eating assistance, making this task appropriate to delegate to the AP. The client’s primary concern may be mobility or pain management, but meal assistance is a routine task.
C. A client who has systemic sclerosis may have issues with gastrointestinal motility and swallowing, requiring more careful feeding assistance and monitoring, which should be performed by the nurse.
D. A client who has amyotrophic lateral sclerosis (ALS) requires specialized care for swallowing difficulties and respiratory issues, making it inappropriate to delegate meal assistance to the AP.
Correct Answer is D
Explanation
Rationale:
A. WBC 6,000/mm³ is within normal range and does not require follow-up.
B. BUN 15 mg/dL is within normal range and does not require follow-up.
C. Hemoglobin 14 g/dL is within normal range for most adults and does not require follow-up.
D. Platelet count 60,000/mm³ is significantly low and requires follow-up as it can increase the risk of bleeding during surgery.