Nursing Elites

1. Which of the following is the most appropriate example of anticipatory guidance for a 16-year-old who has been hospitalized for an ankle fracture?

• A. Changes associated with puberty
• B. Driving and staying safe
• C. The health hazards of smoking
• D. Social media influences

Correct answer: B

Rationale: Anticipatory guidance is an educational process that provides information important to a client's situation. When considering a 16-year-old who has been hospitalized for an ankle fracture, the most suitable anticipatory guidance would be regarding driving and staying safe. This guidance is crucial as it is age-appropriate and relevant to preventing future injuries. Choices A, C, and D are less pertinent in this scenario. Changes associated with puberty, health hazards of smoking, and social media influences may not directly address the immediate safety concerns of a 16-year-old with an ankle fracture.

2. Who owns a patient's x-rays?

• A. The patient
• B. The doctor
• C. The facility that performed the procedure
• D. None of the above

Correct answer: C

Rationale: X-rays are typically owned by the facility that conducts the procedure, not the patient or the doctor. The facility that performs the procedure is responsible for maintaining and storing the x-rays as part of the patient's medical records. The patient does not own the x-rays since they are part of their medical record and not a physical possession. The doctor also does not own the x-rays as they are generated as a result of the medical procedure conducted at the facility, making choice C the correct answer.

3. The nurse is assessing a 3-year-old child for symptoms of autism spectrum disorder (ASD). Which assessment finding should lead the nurse to question the diagnosis?

• A. Inability to react appropriately to social cues
• B. Engages in repetitive behaviors
• C. Comprehends language well beyond the complexity expected for age
• D. Displays self-destructive behavior

Correct answer: C

Rationale: The correct answer is 'Comprehends language well beyond the complexity expected for age.' Children with autism spectrum disorder typically struggle with language and communication skills, so comprehending language well beyond their age level would not align with the diagnosis of ASD. This finding could indicate other developmental strengths or delays. Choices A, B, and D are more commonly associated with ASD - the inability to react appropriately to social cues, engaging in repetitive behaviors, and displaying self-destructive behavior are typical manifestations of autism spectrum disorder.

4. Which example best describes a nurse who exhibits moral courage?

• A. A nurse feels angry when a parent refuses important treatment for his child.
• B. A nurse considers seeking help for depression when she feels she cannot meet the needs of her clients in the oncology unit.
• C. A nurse contacts a physician for further orders when he fails to order comfort measures for a client with a terminal illness.
• D. A nurse is frustrated when the laboratory is slow in responding to an order for a stat blood glucose.

Correct answer: C

Rationale: Moral courage involves taking action to do what is right, even when there might be negative consequences. The nurse who contacted a physician for further orders acted as a client advocate to seek help, even though she may have faced consequences such as lost time, decreased productivity, or criticism from the physician. Choices A, B, and D do not directly involve advocating for a client's needs or challenging a situation that goes against ethical standards. Feeling angry, seeking help for personal issues, or being frustrated with work processes do not necessarily demonstrate moral courage in the context of nursing practice.

5. The client is receiving discharge teaching seven (7) days post myocardial infarction and inquires why he must wait six (6) weeks before engaging in sexual intercourse. What is the best response by the nurse to this question?

• A. "You need to regain your strength before attempting such exertion."?
• B. "When you can climb 2 flights of stairs without problems, it is generally safe."?
• C. "Have a glass of wine to relax you, then you can try to have sex."?
• D. "If you can maintain an active walking program, you will have less risk."?

Correct answer: B

Rationale: Following a myocardial infarction, there is a risk of cardiac rupture at the site of the infarction for approximately six (6) weeks until scar tissue forms. The advice to wait until the client can climb two flights of stairs without issues is common among healthcare providers as it indicates an adequate level of physical exertion tolerance and suggests a lower risk of complications during sexual activity. Choice A is not specific to the recovery timeline related to sexual activity post-myocardial infarction. Choice C is inappropriate as alcohol consumption should not be recommended before sexual activity. Choice D, though promoting an active lifestyle, does not directly address the safety concerns related to sexual intercourse post-myocardial infarction.

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