Nursing Elites

1. Client self-determination is the primary focus of:

• A. malpractice insurance
• B. nursing's advocacy for clients
• C. confidentiality
• D. health care

Correct answer: B

Rationale: Client self-determination refers to the right of clients to make their own decisions about their health care. Nursing's advocacy for clients focuses on upholding this right by supporting and respecting the autonomy and self-determination of clients. This advocacy ensures that clients are empowered to participate in decision-making regarding their health. Confidentiality, while essential, is about maintaining the privacy of client information. Malpractice insurance is a protective measure for professionals in case of errors or negligence. Health care, though crucial for enabling client self-determination, is a broad term encompassing various services and not the primary focus when discussing the client's right to autonomy.

2. The client with schizophrenia has become disruptive and requires seclusion. Which staff member can institute seclusion?

• A. The security guard
• B. The registered nurse
• C. The licensed practical nurse
• D. The nursing assistant

Correct answer: B

Rationale: The registered nurse is the correct choice to institute seclusion for a client with schizophrenia. In healthcare settings, only a registered nurse or a physician can legally initiate seclusion. The security guard, licensed practical nurse, and nursing assistant do not have the authority to carry out this action. Therefore, options A, C, and D are incorrect.

3. When assessing a client for risk of hyperphosphatemia, which piece of information is most important for the nurse to obtain?

• A. A history of radiation treatment in the neck region
• B. A history of recent orthopedic surgery
• C. A history of minimal physical activity
• D. A history of the client's food intake

Correct answer: A

Rationale: The correct answer is a history of radiation treatment in the neck region. Previous radiation to the neck may have damaged the parathyroid glands, which are crucial for calcium and phosphorus regulation. This damage can lead to disruptions in phosphorus levels, increasing the risk of hyperphosphatemia. Choices B, C, and D are not as directly related to phosphorus regulation. Orthopedic surgery, minimal physical activity, and food intake are more closely associated with calcium levels rather than phosphorus regulation. Therefore, it is essential for the nurse to focus on obtaining information about a history of radiation treatment in the neck region when assessing the risk of hyperphosphatemia in a client.

4. The nurse is making assignments for the day. Which client should be assigned to the nursing assistant?

• A. A client with Alzheimer's disease
• B. A client with pneumonia
• C. A client with appendicitis
• D. A client with thrombophlebitis

Correct answer: A

Rationale: The client with Alzheimer's disease is the most stable among the clients listed and can be appropriately assigned to the nursing assistant. Nursing assistants are capable of providing care such as feeding and assisting with activities of daily living for individuals with Alzheimer's disease. Clients with pneumonia, appendicitis, and thrombophlebitis are less stable and necessitate the expertise of a registered nurse for accurate assessment and interventions. Therefore, the nursing assistant can effectively care for the client with Alzheimer's disease while ensuring that the other clients receive the necessary level of care from a registered nurse.

5. A client is admitted with Ewing's sarcoma. Which symptoms would be expected due to this tumor's location?

• A. Hemiplegia
• B. Aphasia
• C. Nausea
• D. Bone pain

Correct answer: D

Rationale: Ewing's sarcoma is a type of bone cancer that primarily affects the bones. Therefore, bone pain would be an expected symptom due to this tumor's location. Hemiplegia, which refers to paralysis on one side of the body, Aphasia, a language disorder, and Nausea are not typical symptoms of Ewing's sarcoma. While Nausea is a common symptom in various conditions, it is not specific to bone cancer like Ewing's sarcoma. Therefore, Bone pain is the most likely symptom associated with Ewing's sarcoma.

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