CELBAN Responding to Healthcare Issues 3 — Questions and Answers
Question 1: A patient from a different cultural background declines a blood transfusion for religious reasons. How should the nurse respond?
- Proceed with the transfusion anyway for the patient's safety
- Respect the patient's decision, document it, and inform the physician (Correct answer)
- Convince the patient that religion should not interfere with medical care
- Ask a senior nurse to override the decision
Correct answer: Respect the patient's decision, document it, and inform the physician
Informed refusal based on religious or cultural beliefs must be respected, documented, and communicated to the physician.
Question 2: A nurse receives a verbal telephone order from a physician. What is the correct procedure?
- Write the order on a napkin and transfer it later
- Repeat the order back to the physician to verify, document it immediately, and have it countersigned within the required timeframe (Correct answer)
- Rely on memory and document the order at the end of the shift
- Refuse to accept verbal orders under any circumstances
Correct answer: Repeat the order back to the physician to verify, document it immediately, and have it countersigned within the required timeframe
Repeat-back verification and timely documentation with countersignature are required protocols for telephone orders.
Question 3: A nurse is caring for a patient who is being discharged but appears confused about their home medication regimen. What is the priority action?
- Hand the patient their discharge papers and wish them well
- Conduct a thorough medication education session and confirm understanding using teach-back (Correct answer)
- Ask the patient to read the instructions at home
- Contact the pharmacy to handle all medication education
Correct answer: Conduct a thorough medication education session and confirm understanding using teach-back
Teach-back is an evidence-based method to confirm patient understanding before discharge and reduce medication errors at home.
Question 4: A nurse witnesses a physician speaking disrespectfully to a patient. What should the nurse do?
- Ignore the situation to avoid conflict with the physician
- Intervene calmly to redirect the conversation and later report the behavior through appropriate channels (Correct answer)
- Side with the physician to maintain team cohesion
- Apologize to the patient on the physician's behalf and take no further action
Correct answer: Intervene calmly to redirect the conversation and later report the behavior through appropriate channels
Nurses have a duty to advocate for patients, which includes addressing disrespectful treatment and reporting it appropriately.
Question 5: A patient expresses suicidal ideation during a routine assessment. What is the nurse's immediate priority?
- Finish the assessment before addressing the comment
- Ensure the patient's immediate safety, stay with them, and notify the physician and mental health team (Correct answer)
- Tell the patient their feelings will improve with time
- Document the statement and continue with other tasks
Correct answer: Ensure the patient's immediate safety, stay with them, and notify the physician and mental health team
Suicidal ideation requires immediate safety measures and rapid notification of the physician and mental health professionals.
Question 6: A nurse is asked by a patient to keep a conversation about substance use secret from other staff. What is the appropriate response?
- Agree to confidentiality to gain the patient's trust
- Explain the limits of confidentiality and that information affecting care or safety must be shared with the team (Correct answer)
- Refuse to discuss the topic at all
- Share the information only with nursing staff, not physicians
Correct answer: Explain the limits of confidentiality and that information affecting care or safety must be shared with the team
Nurses must explain that confidentiality has limits when patient safety or care decisions are affected.
Question 7: During a code blue, a nurse notices chest compressions being performed incorrectly. What is the correct response?
- Remain silent to avoid embarrassing the rescuer
- Calmly and clearly correct the technique or offer to take over compressions (Correct answer)
- Stop the resuscitation to hold a training session
- Report the error after the patient has been stabilized
Correct answer: Calmly and clearly correct the technique or offer to take over compressions
During a code, real-time correction of technique is critical to patient survival and must be done without delay.
CELBAN Responding to Healthcare Issues 3
A patient from a different cultural background declines a blood transfusion for religious reasons.
How should the nurse respond?