Nursing Elites

1. Which of the following statements does NOT apply to a nursing plan of care?

• A. It contains short-term goals
• B. It is developed by the patient's physician
• C. It must be continually evaluated
• D. It contains long-range goals

Correct answer: B

Rationale: The correct answer is B. A nursing plan of care is developed by the nursing staff, not the patient's physician. Choice A is correct as nursing plans of care typically include short-term goals to address immediate needs. Choice C is also accurate as nursing plans of care need to be continually evaluated and updated to ensure they are effective. Choice D is incorrect as nursing plans of care can contain long-range goals to provide a roadmap for the patient's overall care and recovery.

2. Identifying the strengths and weaknesses in the nursing care plan is part of which of the following steps in determining and fulfilling the patient's nursing care needs?

• A. Evaluation
• B. Planning
• C. Implementation
• D. Assessment

Correct answer: A

Rationale: Correct. Evaluation involves assessing the effectiveness of the nursing care plan by identifying its strengths and weaknesses. This step helps in determining if the plan is meeting the patient's needs. Choice B (Planning) is incorrect because planning involves developing the nursing care plan based on the assessment of the patient's needs. Choice C (Implementation) is incorrect as it refers to putting the nursing care plan into action. Choice D (Assessment) is incorrect as assessment is the initial step in the nursing process, involving data collection and analysis to identify the patient's needs.

3. The nurse is teaching the client diagnosed with colon cancer who is scheduled for a colostomy the next day. Which behavior indicates the best method of applying adult teaching principles?

• A. The nurse repeats the information as indicated by the client’s questions
• B. The nurse teaches all the information needed by the client in one session
• C. The nurse uses a video to explain medical terms to the client
• D. The nurse waits until the client asks questions about the surgery

Correct answer: A

Rationale: Choice A is the correct answer because repeating information and addressing the client’s questions as they arise is an effective method for reinforcing learning in adults. This approach allows for immediate clarification and reinforcement of important points. Choice B is incorrect because teaching all the information in one session may be overwhelming for the client and hinder retention. Choice C is incorrect as using a video with medical terms may not necessarily address the client's specific questions or concerns. Choice D is also incorrect because waiting for the client to ask questions may lead to missed opportunities for providing crucial information and addressing uncertainties.

4. Which referral would be most appropriate for the client diagnosed with thoracic outlet syndrome?

• A. The physical therapist
• B. The thoracic surgeon
• C. The occupational therapist
• D. The social worker

Correct answer: C

Rationale: The correct answer is C, the occupational therapist. An occupational therapist specializes in helping individuals with activities of daily living, ergonomic assessments, and adaptive techniques. In the case of thoracic outlet syndrome, an occupational therapist can provide exercises and adaptations to improve the client's function and alleviate symptoms. Choosing the physical therapist (choice A) may also be beneficial for rehabilitation exercises, but occupational therapists focus more on functional activities. Referring to a thoracic surgeon (choice B) would be more appropriate for surgical interventions rather than initial management. Referring to a social worker (choice D) may not directly address the physical symptoms and functional limitations associated with thoracic outlet syndrome.

5. The nurse administers 2 units of salt-poor albumin to a client with portal hypertension and ascites. The nurse explains to the client that this is administered to:

• A. Provide nutrients
• B. Increase protein stores
• C. Elevate the circulating blood volume
• D. Divert blood flow away from the liver temporarily

Correct answer: C

Rationale: The correct answer is C: Elevate the circulating blood volume. Salt-poor albumin is given to increase the circulating blood volume, which helps reduce ascites by improving fluid distribution within the body. Choices A, B, and D are incorrect because salt-poor albumin is not administered to provide nutrients, increase protein stores, or divert blood flow away from the liver.

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