Nursing Elites

1. Which of the following statements by a client indicates adequate understanding of preparation for a lipoprotein fractionation test?

• A. "I cannot eat or drink after midnight."?
• B. "I cannot eat for 12 hours before the test."?
• C. "I need to limit my fluid intake."?
• D. "I need to ingest a lipid solution."?

Correct answer: B

Rationale: The correct statement regarding preparation for a lipoprotein fractionation test is that the client cannot eat for 12 hours before the test. It is important to note that the client can drink an unrestricted amount of water. Limiting fluid intake is not necessary for this test. There is no need for the client to ingest a lipid solution as part of the preparation. Therefore, the other choices are incorrect.

2. A nurse is planning the assignments for the shift. Which task should the nurse assign to the nursing assistant?

• A. Monitoring the vital signs for a client who needs a blood transfusion
• B. Performing hygiene for a client with diarrhea on whom contact precautions have been imposed
• C. Performing a dressing change on a client with a draining abdominal wound that requires frequent dressing changes
• D. Ambulating a client with angina who needs to be ambulated for the first time since admission

Correct answer: B

Rationale: When assigning tasks, a nurse should consider the job description of the nursing assistant, their clinical competence, and state law. Monitoring vital signs for a client needing a blood transfusion, performing a dressing change on a client with a draining wound, and ambulating a client with angina are tasks that require a licensed nurse's skill. On the other hand, providing hygiene care for a client with diarrhea under contact precautions is a task suitable for a nursing assistant. Nursing assistants are trained to provide hygiene care effectively and manage clients under specific precautions, making this task appropriate for them.

3. The ICU nurse caring for a client who has just been declared brain dead can expect to find evidence of the client's wishes regarding organ donation:

• A. on the client's driver's license.
• B. in the client's safety deposit box.
• C. in the client's last will and testament.
• D. on the client's insurance card.

Correct answer: A

Rationale: In most states, indication of organ donor status is found on the client's driver's license, making it easily accessible for decision-making in critical situations like declaring brain death. Evidence in a last will and testament or a safety deposit box may not be promptly available. Information about organ donation is typically not included on insurance cards. The primary care physician's health record documentation could also be a relevant source for the ICU nurse. Therefore, the correct answer is finding evidence of the client's wishes regarding organ donation on the client's driver's license.

4. The laws enacted by states to provide immunity from liability to persons who provide emergency care at an accident scene are called:

• A. Good Samaritan laws.
• B. HIPAA.
• C. Patient Self-Determination Act (PSDA).
• D. OBRA.

Correct answer: A

Rationale: The correct answer is Good Samaritan laws. These laws protect individuals who provide voluntary emergency care from being held liable for any unintended injury or harm that may occur during the care. Good Samaritan laws encourage individuals to assist in emergencies without fear of legal repercussions. HIPAA, on the other hand, focuses on safeguarding patient information and privacy, ensuring confidentiality. The Patient Self-Determination Act (PSDA) pertains to a patient's rights to make decisions about their medical treatment and advance directives. OBRA, enacted in the late 1980s, aims to improve the quality of care in nursing homes and enhance residents' quality of life, focusing on nursing home reform and standards, which is not directly related to immunity for emergency care providers.

5. When a drug is listed as Category X and prescribed to women of child-bearing age/capacity, the nurse and the interdisciplinary team should counsel the client that:

• A. Pregnancy tests are not reliable while taking the drug.
• B. She must use a reliable form of birth control.
• C. She should not take the Category X drug on days she has intercourse.
• D. She must follow up with an endocrinologist.

Correct answer: B

Rationale: When a drug is categorized as Category X, it signifies that there are significant risks of fetal abnormalities if taken during pregnancy. For this reason, women of child-bearing age/capacity should use reliable forms of birth control to prevent pregnancy while on the medication. This ensures that the client avoids the potential harm to the fetus. Option A is incorrect because pregnancy tests are not unreliable due to the drug, but rather the risk is related to potential harm to the fetus. Option C is incorrect as avoiding the drug only on days of intercourse does not provide sufficient protection against pregnancy. Option D is incorrect as the need for an endocrinologist is not directly related to the use of Category X drugs.

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