A nurse has designed an individualized nursing care plan for a ...

[CQXA]

A nurse has designed an individualized nursing care plan for a patient, but the patient is not meeting the goals. Further assessment reveals that the patient is not following through on many items.
 
  Which action by the nurse would be best for determining the cause of the problem?
  a. Assess whether the actions were too hard for the patient.
  b. Determine whether the patient agrees with the care plan.
  c. Question the patient's reasons for not following through.
  d. Reevaluate data to ensure the diagnoses are sound.

Question 2

A nurse has volunteered to practice in a disaster area in a developing country where supplies are extremely scarce. Despite bringing large amounts of supplies to the area, the volunteer group members find they are still very limited.
 
  The volunteer group decides to focus on providing care according to the ethical concept of utilitarianism. Which action by the group would best fit under this philosophy?
  a. Choosing to treat children and pregnant women as priorities
  b. Converting vehicles into ambulances for transport to hospitals
  c. Establishing a mobile ventilator unit for critically ill patients
  d. Providing clean water, food, shelter, and basic health care

[zogaridan]

Answer to Question 1

B
Having patient or family input to the care plan is vital in order to gain support for the plan of action.
The actions may have been too difficult for the patient, but this is a very narrow item to focus on.
The nurse might want to find out the rationale for the patient not following through, but instead of directly questioning the patient, which can sound accusatory, it would be best to offer some possible motives.
Reevaluation should be an ongoing process, but the more likely cause of the patient's failure to follow through is that the patient did not participate in making the plan of care.

Answer to Question 2

D
Utilitarianism focuses on doing the greatest good for the largest number of people. Presumably, the majority of people need fresh water; good food; shelter from the elements; and basic health care such as wound suturing, immunizations, and antibiotics.
Choosing to treat children and pregnant women as priorities would be acting according to a perceived duty (assuming these patients are perceived as more important somehow), so this would be more in line with deontology.
Converting vehicles into ambulances for transport to hospitals would not help the largest number of people, most of whom do not require hospitalization.
Establishing a mobile ventilator unit for critically ill patients would only help a small number of people.

[CQXA]

TYSM

[Chelseyj.hasty]

Excellent