Nursing Elites

1. A client scheduled for surgery cannot sign the operative consent form because he has been sedated with opioid analgesics. The nurse should take which best action regarding the informed consent?

• A. Obtain a court order for the surgery
• B. Sign the informed consent on behalf of the client
• C. Send the client to surgery without the consent form being signed
• D. Obtain a telephone consent from a family member, with the consent being witnessed by two healthcare providers

Correct answer: D

Rationale: In situations where a client is unable to sign the consent form, obtaining a telephone consent from a family member, with the consent being witnessed by two healthcare providers, is the best course of action. This ensures that the client's best interests are considered and that proper authorization is obtained. Option A, obtaining a court order, is not necessary in this scenario and could delay the surgery. Option B, signing the consent on behalf of the client, is not appropriate as it may raise ethical and legal concerns. Option C, sending the client to surgery without a signed consent form, is not advisable as it violates the principles of informed consent and places the client at risk.

2. An important part of nutrition therapy for patients with cystic fibrosis is:

• A. A low-fat diet to prevent steatorrhea
• B. A low-sodium diet to normalize fluid status
• C. A high-fiber diet to normalize bowel function
• D. Pancreatic enzyme replacement therapy to help digestion

Correct answer: D

Rationale: The correct answer is D: Pancreatic enzyme replacement therapy to help digestion. In cystic fibrosis, pancreatic insufficiency leads to the malabsorption of nutrients, making it essential for patients to take pancreatic enzymes to aid in digestion. Options A, B, and C are incorrect because a low-fat diet may not provide adequate nutrition for cystic fibrosis patients, a low-sodium diet is not the primary focus of nutrition therapy in cystic fibrosis, and a high-fiber diet may exacerbate gastrointestinal symptoms due to malabsorption.

3. Which of the following is a specialized medical treatment and teaching facility that provides general and specialized medical and dental care and treatment?

• A. CONUS
• B. MEDCEN
• C. MEDCOM
• D. MEDDAC

Correct answer: B

Rationale: The correct answer is B, MEDCEN, which stands for Medical Center. A MEDCEN is a specialized medical treatment and teaching facility that provides general and specialized medical and dental care and treatment. Choices A, C, and D are incorrect. CONUS refers to the continental United States and is not a medical facility. MEDCOM stands for Medical Command, which is an organization rather than a specific facility for medical treatment. MEDDAC stands for Medical Department Activity and is also an organization responsible for medical care delivery, not a specific treatment facility.

4. The client diagnosed with diabetes mellitus type 2 is admitted to the hospital with cellulitis of the right foot secondary to an insect bite. Which intervention should the nurse implement first?

• A. Administer intravenous antibiotics
• B. Apply warm moist packs every two hours
• C. Elevate the right foot on two pillows
• D. Teach the client about skin and foot care

Correct answer: A

Rationale: Administering intravenous antibiotics is the priority intervention in this scenario. Cellulitis is a bacterial skin infection that requires prompt treatment with antibiotics to prevent its spread and potential complications. While warm moist packs and elevation can be beneficial as adjunct measures, they are not the initial priority. Teaching about skin and foot care is important, but it can be addressed after stabilizing the acute condition with antibiotics.

5. A patient with hypothyroidism should be advised to consume more of which nutrient?

• A. Calcium
• B. Iodine
• C. Vitamin C
• D. Iron

Correct answer: B

Rationale: The correct answer is B: Iodine. Iodine is essential for thyroid hormone production, and its deficiency can contribute to hypothyroidism. While calcium, vitamin C, and iron are important for overall health, they are not specifically related to thyroid function. Calcium is more associated with bone health, vitamin C with immune function, and iron with red blood cell production.

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