Detailed Answer Key
Leadership Quiz II
1.A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client
reports that he had to increase the dose of morphine this week
...
Detailed Answer Key
Leadership Quiz II
1.A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client
reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following
scenarios should the nurse document as the explanation for this situation?
A. The client not been taking the medication properly.
Rationale: The nurse should not document the client has not been taking the medication properly without
further investigation. The client is able to tell the nurse that he had to increase the dose, which
does not indicate taking the medication improperly.
B. The client is experiencing episodes of confusion.
Rationale: The nurse should not document the client is experiencing confusion. The client is clearly able to
tell the nurse that that he had to increase the dose to achieve pain relief. This does not indicate
the client is confused.
C. The client has become addicted to the medication.
Rationale:Addiction is the compulsive need for and use of a habit-forming substance, such as a narcotic.
However, this client is not describing addiction, and addiction is not a concern when treating a
terminal client who has cancer pain.
D. The client developed a tolerance to the medication.
Rationale: The nurse should document that the client has developed a tolerance to the medication.
Morphine is a narcotic analgesic used for the treatment of severe pain. Tolerance is an adverse
effect of narcotic analgesics in which a larger dose is needed to produce the same response.
2.A nurse is caring for a client who has advanced lung cancer. The client’s provider has recommended hospice
services for the client. Which of the following statements by the client indicates a correct understanding of hospice
care?
A. "I will have to be admitted to a long-term care facility in order to receive hospice care."
Rationale: Hospice care is provided in a long-term care facility; however, hospice care is also provided in a
number of other settings, including the client’s home and in an assisted living facility.
B. "I should expect the hospice team to help me manage my dyspnea."
Rationale: Dyspnea is a manifestation of terminal lung cancer. The primary purpose of hospice care is to
provide relief of symptoms related to a terminal illness.
C. "Hospice care services are available to patients who are terminally ill regardless of their life expectancy."
Rationale: Hospice care is available to clients who have a prognosis of 6 months or fewer to live.
D. "My oncologist will continue to look for a cure for my cancer while I am receiving hospice care."
Rationale: Hospice care provides comfort care for the client, but does not include curative treatment.
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Detailed Answer Key
Leadership Quiz II
3.A nurse is teaching a class on torts. The nurse should instruct the class that administering an antibiotic medication
to a competent client after the client has refused it is an example of which of the following torts?
A. Assault
Rationale:Assault is the act of verbally threatening a client. A nurse who verbally threatens to give a
medication to a client without the client’s consent is committing assault.
B. False imprisonment
Rationale: False imprisonment is detaining a client against her will without legal warrant. A nurse who
administers a chemical restraint without the client’s consent is committing false imprisonment.
C. Negligence
Rationale: Negligence is a breach of duty that results in harm to the client. A nurse who administers an
incorrect medication to a client is committing professional negligence.
D. Battery
Rationale:Battery is physical contact without the client’s consent. Administering a medication against a
client’s wishes is an example of battery.
4.A nurse is caring for a client who has cancer and is receiving palliative care. Which of the following statements by
the client indicates they understand this type of treatment?
A. “I am thinking of getting a second opinion.”
Rationale: Clients receiving palliative care should be aware that there is no hope of cure or recovery and
would not seek a second opinion.
B. “I am hoping this will limit my discomfort.”
Rationale: Clients receiving palliative care are aware that the outcome is to prevent suffering and provide
the best possible quality of life.
C. “This treatment should help me live a little longer.”
Rationale:Palliative care does not attempt to hasten or postpone death, it is in place to provide relief from
pain and other discomforts of the disease process.
D. “This is not working and I plan to stop treatment.”
Rationale: Clients receiving palliative care should be aware that there is no hope for cure or recovery and
would accept ongoing support to prevent suffering and maintain the best possible quality of life.
5.A nurse is providing palliative care to a client whose partner asks why music therapy might help her. Which of the
following responses should the nurse make? (Select all that apply.)
A. "Music therapy will increase her basal metabolic rate."
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Detailed Answer Key
Leadership Quiz II
B. "Music therapy can help her verbally express emotions."
C. "Music therapy will improve her appetite and decrease the nausea."
D. "Music therapy works as a distraction and can help alleviate her pain."
E. "Music therapy can help facilitate movement in some clients who have mobility limitations."
Rationale:"Music therapy will increase her basal metabolic rate" is incorrect. The basal metabolic rate is
the energy a person needs for life-sustaining activities such as breathing and maintaining
circulation at rest. Music therapy relaxes and calms, which would decrease energy expenditure
rather than increasing it."Music therapy can help her verbally express emotions" is correct.
Music therapy helps improve communication and develop emotional expression."Music therapy
will improve her appetite and decrease the nausea" is incorrect. Music relaxes and calms but
does not necessarily increase appetite or reduce nausea. Measures to increase a client's
appetite include offering the client small portions of her favorite foods, providing oral hygiene,
and keeping the client comfortable."Music therapy works as a distraction and can help alleviate
her pain" is correct. Music therapy helps distract people from pain. Music often calms and
relaxes clients, diverting their attention away from the pain."Music therapy can help facilitate
movement in some clients who have mobility limitations" is correct. Music therapy improves
physical movement, especially for clients who are ill or have disabilities.
6.A nurse administers an incorrect medication to a client. Following an assessment of the client, the nurse determines
that the client has experienced no untoward effects as a result of the medication. The nurse does not complete an
incident report because no harm came to the client. Which of the following ethical principles did the nurse violate?
A. Autonomy
Rationale:Although the nurse is acting autonomously, it is not on behalf of the client. Autonomy involves
accepting responsibility for one’s choices and meeting organizational expectations.
B. Beneficence
Rationale:Beneficence means helping others to promote good. The nurse’s failure to report the medication
error does not help the client if the client experiences adverse effects at a later date.
C. Veracity
Rationale:Veracity is the duty to tell the truth. The nurse violated the ethical principle of veracity when
choosing not to report the error instead of being truthful.
D. Confidentiality
Rationale: Confidentiality means disclosing information about a client only to those involved in the client’s
care. Reporting the error discloses the nurse’s potentially harmful action to others who are
involved in the client’s care and who can monitor the client accordingly.
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