Nursing Elites

1. When does the nurse act as a client advocate?

• A. Pulling the curtain around the client's bed while changing a dressing
• B. Contacting the health care provider to request a meeting for the client
• C. Ensuring access to medical information by appropriate personnel only
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Acting as a client advocate involves various actions to protect the client's rights and well-being. Pulling the curtain around the client's bed while changing a dressing ensures privacy and dignity. Contacting the health care provider to request a meeting for the client facilitates communication and addresses the client's needs. Ensuring access to medical information by appropriate personnel only safeguards the client's confidentiality and privacy. Therefore, all the actions mentioned in choices A, B, and C are examples of a nurse acting as a client advocate, making D the correct answer.

2. A client is admitted to the hospital with the diagnosis of a right-sided brain attack (CVA). The client is right-handed. Which task will be most difficult for this client?

• A. Eating meals
• B. Writing letters
• C. Combing the hair
• D. Dressing every morning

Correct answer: B

Rationale: The correct answer is B: Writing letters. Writing requires fine motor skills, which are often impaired in a right-handed person with a right-sided CVA. Eating meals (choice A) involves gross motor skills and can be adapted for easier handling. Combing the hair (choice C) and dressing every morning (choice D) also require fine motor skills, but they are generally less complex and demanding than writing letters.

3. When a field medical element is not operational, it engages in training to achieve readiness for mobilization that involves all aspects of operation. Individuals must be proficient in their MOS/ASI and which of the following?

• A. Command and control procedures
• B. Computers and data processing
• C. Common soldier tasks
• D. Communications and automation

Correct answer: C

Rationale: In the context of field medical training for mobilization, proficiency in common soldier tasks is essential. This includes skills like first aid, navigation, marksmanship, and other fundamental military tasks. While command and control procedures, communications, and automation are important, common soldier tasks are specifically mentioned in the scenario as critical for achieving readiness and mobilization.

4. The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?

• A. Discontinue the heparin drip prior to initiating the Coumadin
• B. Check the client’s INR prior to beginning Coumadin
• C. Clarify the order with the health care provider as soon as possible
• D. Administer the Coumadin along with the heparin drip as ordered

Correct answer: D

Rationale: The correct action for the nurse to take is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip prior to initiating Coumadin could leave the patient without anticoagulation coverage during the period when warfarin's effects are not yet established. Checking the client's INR prior to beginning Coumadin is important but not the immediate action to take when both medications are ordered together. Clarifying the order with the health care provider is unnecessary in this scenario as it is common practice to give heparin and warfarin concurrently in the transition period.

5. What is the most crucial and most difficult management skill required of the M6 practical nurse?

• A. Preparing time schedules and task assignment rosters
• B. Inspecting equipment for damage and proper function
• C. Preparing reports and maintaining records
• D. Effectively managing personnel

Correct answer: D

Rationale: The correct answer is D: Effectively managing personnel. In a healthcare setting, managing personnel is crucial as it involves leading, motivating, and coordinating the healthcare team to ensure quality patient care. While tasks like preparing schedules, inspecting equipment, and maintaining records are important, managing personnel involves dealing with human factors, conflicts, and emotions, making it the most challenging skill for a practical nurse.

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