Nursing Elites

1. A nurse is asked to perform a task that she believes is outside her scope of practice. What is the appropriate response to this issue?

• A. Contact the state board of nursing licensure to report the offense
• B. Review the state scope of practice standards for nurses
• C. Ask another nurse to perform the task to learn the procedure
• D. Contact the house supervisor to make the decision on whether the nurse should perform the task

Correct answer: B

Rationale: When faced with a task that a nurse believes may be beyond their scope of practice, it is essential to refer to the state's specific scope of practice standards for nurses. This step is crucial as these standards can vary between states, providing clarity on what tasks are permissible. By reviewing these standards, the nurse can determine if the task falls within their scope of practice. Contacting the state board of nursing licensure to report the offense (Choice A) is premature and should only be considered if there is a serious violation after reviewing the scope of practice. Asking another nurse to perform the task (Choice C) does not address the issue of clarifying the scope of practice. Contacting the house supervisor (Choice D) may be necessary if the nurse cannot determine the appropriateness of the task based on the scope of practice standards.

2. When teaching a Vietnamese patient who has been treated for pneumonia and needs to complete her antibiotic regimen at home, what is an important cultural component to consider?

• A. Cupping will help to pull toxins from the body
• B. Coining will help to release the wind or bad energy from the body
• C. Once symptoms disappear there is no longer an illness
• D. Most households consist of at least 3 generations

Correct answer: C

Rationale: The correct answer is 'Once symptoms disappear there is no longer an illness'. In Vietnamese culture, there is a belief that once symptoms go away, the illness is no longer present and does not require further treatment. This is crucial to understand when educating Vietnamese patients about completing their antibiotic regimen. Choices A and B (cupping and coining) are traditional Vietnamese healing practices that are not directly related to completing antibiotic therapy. Choice D, about households consisting of multiple generations, is not directly relevant to the completion of antibiotic treatment for pneumonia in this context.

3. The OR nursing staff are preparing a client for a surgical procedure. The anesthesiologist has given the client medications, and the client has entered the induction stage of anesthesia. The nursing staff can expect which of the following symptoms and activities from the client during this time?

• A. Irregular breathing patterns
• B. Minimal heartbeat, dilated pupils
• C. Relaxed muscles, regular breathing, constricted pupils
• D. Euphoria, drowsiness, dizziness

Correct answer: D

Rationale: During the induction stage of anesthesia, the client may exhibit symptoms like euphoria, drowsiness, or dizziness. This stage occurs after the administration of medications by the anesthesiologist and ends when the client loses consciousness. Choice A is incorrect as irregular breathing patterns are not typically associated with the induction stage. Choice B is incorrect as minimal heartbeat and dilated pupils are not commonly observed during this stage. Choice C is incorrect as relaxed muscles, regular breathing, and constricted pupils are not indicative of the induction stage of anesthesia.

4. Mobility is an important human function. The hazards of immobility lead to many physical and emotional problems. Immobility can lead to detrimental cardiac, muscular, respiratory, skeletal, urinary, gastrointestinal, skin, and emotional changes. Which of the following is an example of a skeletal hazard of immobility?

• A. Contractures.
• B. Constipation.
• C. Calcium loss.
• D. Catabolism.

Correct answer: C

Rationale: All choices are hazards of immobility, but only calcium loss from the bones is a skeletal system impairment that results from immobility. Contractures are muscle shortening due to prolonged positioning, which affects the muscular system. Constipation is a gastrointestinal issue. Catabolism is a metabolic process, not specific to the skeletal system.

5. A child has recently been diagnosed with Duchenne muscular dystrophy (DMD). The parents are receiving genetic counseling prior to planning another pregnancy. Which of the following statements includes the most accurate information?

• A. Duchenne is an X-linked recessive disorder, so daughters have a 50% chance of being carriers and sons a 50% chance of developing the disease.
• B. Duchenne is an X-linked recessive disorder, so both daughters and sons have a 50% chance of developing the disease.
• C. Each child has a 1 in 4 (25%) chance of developing the disorder.
• D. Sons only have a 1 in 4 (25%) chance of developing the disorder.

Correct answer: A

Rationale: The correct answer is that Duchenne is an X-linked recessive disorder, meaning the affected gene is located on one of the two X chromosomes of a female carrier. If a son receives the X chromosome bearing the gene, he will develop the disease, giving him a 50% chance of being affected. Daughters, on the other hand, are not affected by Duchenne but have a 50% chance of being carriers since they inherit one copy of the defective gene from the mother. The other X chromosome is inherited from the father, who cannot be a carrier. Therefore, choice A is accurate. Choice B is incorrect because daughters do not develop the disease, and sons have a 50% chance of developing, not both having a 50% chance. Choice C is incorrect as it does not consider the X-linked inheritance pattern of Duchenne. Choice D is inaccurate as it incorrectly states that only sons have a 25% chance of developing the disorder, omitting the carrier status of daughters.

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