Nursing Elites

1. Who may legally give informed consent?

• A. an 86-year-old male with advanced Alzheimer's disease
• B. a 14-year-old girl needing an appendectomy who is not an emancipated minor
• C. a 14-year-old girl needing an appendectomy who is not an emancipated minor
• D. a 6-month-old baby needing bowel surgery

Correct answer: C

Rationale: The correct answer is a 14-year-old girl needing an appendectomy who is not an emancipated minor. Informed consent can be given by individuals who are competent and not minors. Minors are generally unable to provide informed consent unless they are emancipated. Choice A is incorrect because an 86-year-old male with advanced Alzheimer's disease is considered incompetent to make decisions. Choice D is incorrect because a 6-month-old baby is unable to provide consent. Emancipated minors are an exception to the minor rule, as they can provide consent for their own treatment.

2. Two staff nurses were considered for promotion to head nurse. The promotion is announced via a memo on the unit bulletin board. The nurse who was not promoted tells a friend, "Oh, well, I really didn't want the job anyway."? This is an example of:

• A. rationalization.
• B. denial.
• C. projection.
• D. compensation.

Correct answer: A.

Rationale: This is an example of rationalization, specifically the sour grapes form, where the individual convinces themselves that they didn't want something after realizing they couldn't have it. Rationalization is an unconscious form of self-deception involving making excuses. In this scenario, the nurse is rationalizing her disappointment by downplaying her desire for the promotion. Denial involves ignoring the existence of a situation, which is not demonstrated here. Projection involves blaming others unconsciously, which is also not present in this situation. Compensation is an attempt to offset a perceived weakness by emphasizing a strong point, which is not shown in the nurse's response.

3. How does the ANA define the psychiatric nursing role?

• A. a specialized area of nursing practice that employs theories of human behavior as its science and the powerful use of self as its art
• B. assisting the therapist to relieve the symptoms of clients
• C. to solve clients' problems and give them the answers
• D. having a client committed to long-term therapy with the nurse

Correct answer: A

Rationale: The correct answer aligns with the ANA's definition of the psychiatric nursing role. According to the ANA, psychiatric nursing is a specialized area of nursing practice that incorporates theories of human behavior as its foundational science and utilizes the self as its essential art. This definition emphasizes the importance of understanding human behavior and leveraging therapeutic communication and relationships to provide effective care for individuals with mental health concerns. Choices B, C, and D are incorrect because they do not accurately represent the ANA-defined role of psychiatric nursing. Psychiatric nurses primarily focus on delivering holistic care, promoting mental health, and supporting individuals with mental health challenges using evidence-based practices and therapeutic interventions.

4. Which of the following roommates would be best for the client newly admitted with gastric resection?

• A. A client with Crohn's disease
• B. A client with pneumonia
• C. A client with gastritis
• D. A client with phlebitis

Correct answer: D

Rationale: The most suitable roommate for the client newly admitted with gastric resection is the client with phlebitis. Phlebitis is an inflammation of the blood vessel and is not infectious, making it a safer option for the surgical client. Crohn's disease clients (choice A) have frequent stools that might spread infections to the surgical client, posing a risk. A client with pneumonia (choice B) is coughing, which can disturb the gastric client's recovery. Additionally, a client with gastritis (choice C) who is vomiting and experiencing diarrhea would also not be an ideal roommate for a client recovering from gastric resection.

5. An elderly client is diagnosed with ovarian cancer. She has surgery followed by chemotherapy with fluorouracil (Adrucil) IV. What should the nurse do if she notices crystals and cloudiness in the IV medication?

• A. Discard the solution and order a new bag
• B. Warm the solution
• C. Continue the infusion and document the finding
• D. Discontinue the medication

Correct answer: A

Rationale: Crystals in the solution are not normal and should not be administered to the client. Discarding the solution and ordering a new bag is the correct action to ensure the client's safety. Warming the solution, as suggested in answer B, will not resolve the issue of crystals and cloudiness, which could potentially harm the client. Continuing the infusion, as in answer C, could pose a risk to the client due to the presence of abnormal substances. Answer D, discontinuing the medication, would typically require a doctor's order and should be done after discarding the contaminated solution.

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