Nursing Elites

1. Which of the following is an example of whistle-blowing?

• A. A nurse contacts administration about a colleague who takes supplies to use for a mission trip
• B. A client sues a nurse because she failed to call the physician about his wound infection
• C. A nursing assistant calls for help when a client falls out of bed
• D. A client developed a sacral pressure ulcer when he was not turned in bed for over four hours

Correct answer: A

Rationale: Whistle-blowing involves notifying administration or a supervisor about unethical or illegal activities. In this scenario, the nurse reporting a colleague taking supplies for personal use is an example of whistle-blowing as it involves reporting behavior that is dishonest and potentially harmful. Choices B, C, and D do not represent whistle-blowing. Choice B involves a legal action by a client against a nurse, choice C is a situation where immediate care is provided, and choice D is a case of neglect that should have been prevented.

2. Which example best describes the concept of beneficence?

• A. A nurse provides pain medication for a client in the recovery room who is experiencing pain
• B. A client has an advanced directive in place stating that he does not want intubation if he needs CPR
• C. At the request of the client, a nurse does not inform the family about his cancer diagnosis
• D. A nurse withholds narcotic medication for a client in pain, knowing that he is currently disoriented

Correct answer: A

Rationale: Beneficence is the ethical principle of doing good and acting in the best interest of the client. Providing pain relief to a client in the recovery room who is experiencing pain aligns with beneficence as it promotes the client's well-being and comfort. Choice B is related to autonomy, where the client's wishes regarding treatment are respected. Choice C involves confidentiality and the client's right to privacy. Choice D represents nonmaleficence, as withholding pain medication from a client in pain could cause harm and goes against the principle of doing no harm.

3. Which of the following nursing interventions is appropriate for a client suffering from a fever?

• A. Avoid withholding food from the client
• B. Increase the client's fluid intake
• C. Provide oxygen
• D. All answers are correct

Correct answer: B

Rationale: The appropriate nursing intervention for a client suffering from a fever is to increase the client's fluid intake. A fever can elevate the body's metabolism, leading to increased breathing and heart workload. This can result in fluid loss due to heightened respiration and sweating. Moreover, the augmented heart workload may necessitate more oxygen to maintain tissue perfusion. Providing oxygen and increasing fluid intake help meet the body's heightened demands during a fever. Withholding food from the client is inappropriate as proper nutrition is crucial for recovery, and providing oxygen alone may not address the fluid and metabolic demands associated with fever. Therefore, the correct choice is to increase the client's fluid intake.

4. You are taking care of Mary Eden, an elderly and frail 91-year-old resident. She gets confused during evening hours and at times she thinks that she hears her daughter calling her from the other side of the nursing home. Which physical problem places Mary Eden at risk for falls?

• A. Her confusion
• B. Her daughter
• C. Evening hours
• D. Her frailness

Correct answer: D

Rationale: Mary Eden's frail and weak muscles due to her age and physical condition place her at risk for falls. While her confusion can contribute to falls, it is considered an emotional or cognitive issue rather than a physical problem. Her daughter and the evening hours are not physical problems that directly increase her risk of falling.

5. Family members of a patient ask repeated questions about the monitors and various readings in the patient's room. What is the most supportive response to their questions?

• A. Inform them that you can't take the time to answer all their questions
• B. Provide detailed explanations for each device
• C. Tell them it's too technical to explain
• D. Provide an overview and encourage them to spend their time with the patient

Correct answer: D

Rationale: Addressing the family's questions and providing an overview of information validates their concerns and addresses their requests. Limiting details and encouraging them to focus on the patient helps to avoid anxiety that could be created by focusing on values that should be interpreted in the context of the patient's situation by professionals with experience with such data. It also encourages them to provide what they uniquely have to offer: a comforting presence for their loved one. Choice A is dismissive and does not address the family's needs. Choice B may overwhelm the family with unnecessary technical information. Choice C is unhelpful as it disregards the family's genuine interest and concern. Therefore, choice D is the most appropriate response as it balances providing information while guiding the family to focus on supporting the patient.

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