Contemporary Ethical Issues in Nursing

Correct Answer: A

Rationale: The correct answer is A because most states require certification for all specialty roles identified as advanced practice. This is crucial for ensuring that nurse practitioners have met specific educational and clinical practice requirements to provide safe and competent care. Explanation for why other choices are incorrect: B: Nurse anesthetists and nurse-midwives are not the only advanced practice roles that require certification in most states. Other roles such as nurse practitioners and clinical nurse specialists also require certification. C: The increasing number of new advanced practice roles does not necessarily mean that the scope of practice remains unclear in state nurse practice acts. Certification requirements help define the scope of practice for each role. D: Certification is not automatic when applying for an advanced practice license. Nurses must complete specific educational programs and pass certification exams to obtain certification for their chosen specialty role.

Correct Answer: C

Rationale: The correct answer is C: mediation. In this scenario, a trained member listened to both parties (nurses and management) and made recommendations that were not legally binding. Mediation involves a neutral third party facilitating communication and negotiation between conflicting parties to help them reach a mutually acceptable resolution. It is non-binding, unlike binding arbitration, where a decision is imposed on the parties. Picketing involves organized striking by employees to protest against employer practices. Grievance is a formal complaint process within an organization. Mediation is the appropriate term for this non-binding settlement process in this context.

Correct Answer: C

Rationale: The correct answer is C because nursing judgment related to withholding medication based on vital signs requires critical thinking, clinical knowledge, and experience. This decision-making process involves assessing the patient's condition, interpreting vital signs, and determining if medication should be given or withheld to ensure patient safety. This function cannot be delegated to someone without the appropriate training and expertise. A: Assessment of skin integrity on the third day of hospitalization can be delegated to other healthcare team members such as LPNs or nursing assistants, as long as they have been trained and deemed competent. B: Evaluation of patient teaching related to turn, cough, and deep breathing exercises can be delegated to other healthcare team members, as long as they have the appropriate training and supervision. D: The statement that RNs do not delegate to other RNs is incorrect. RNs can delegate certain tasks to other RNs based on their scope of practice and level of experience. It is not limited to LPNs or unlicensed assistive personnel.

Correct Answer: B

Rationale: The correct answer is B because obtaining the clinical nurse leader certification denotes that the individual has met the minimum level of knowledge and skills required to practice safely in that role. This certification does not grant independent practice authority as in choice C, nor is it granted by the state board of nursing as stated in choice A. Additionally, while the certification recognizes advanced skills and knowledge, it specifically signifies the minimum level needed for safe practice, making choice D incorrect.

Correct Answer: B

Rationale: The correct answer is B because the scenario describes a situation appropriate for the supervisory level of initial direction and periodic inspection. The RN assigning tasks to the LPN within her scope of practice and checking back ensures tasks are completed correctly, aligning with the supervisory role. This level of oversight is necessary for safe and effective patient care. Choice A is incorrect as experienced RNs working together do not require supervisory direction for caring for patients. Choice C involves the charge nurse providing frequent oversight to a new graduate nurse, which is more than just periodic inspection. Choice D is incorrect because regardless of both being registered nurses, supervision may still be necessary, especially when assigning tasks to a different level of healthcare provider like an LPN.