Nursing Elites

1. A 24-year-old female client is scheduled for surgery in the morning. What is the primary responsibility of the nurse?

• A. Taking the vital signs
• B. Obtaining the permit
• C. Explaining the procedure
• D. Checking the lab work

Correct answer: A

Rationale: The primary responsibility of the nurse is to take the vital signs before any surgery. This action helps assess the client's baseline condition and identify any abnormalities that need addressing before the procedure. Obtaining the permit (choice B) is typically handled by administrative staff, explaining the procedure (choice C) is usually done by the healthcare provider performing the surgery, and checking the lab work (choice D) is often part of the pre-operative assessment conducted by the healthcare provider. Therefore, in this context, these actions are not the primary responsibility of the nurse.

2. Upon arrival at the emergency room, the client presents with severe burns to the left arm, hands, face, and neck. What action should take priority?

• A. Starting an IV
• B. Applying oxygen
• C. Obtaining blood gases
• D. Medicating the client for pain

Correct answer: B

Rationale: In a client with severe burns to the face and neck, airway assessment and supplemental oxygen are crucial. Therefore, applying oxygen is the priority to ensure adequate oxygenation for the client. This intervention takes precedence over other actions to stabilize the client's condition. Starting an IV for fluid resuscitation is the next appropriate step following ensuring oxygenation (Choice A). While pain management is important, it is a secondary priority after ensuring oxygenation and fluid resuscitation, making medicating the client for pain a later intervention (Choice D). Obtaining blood gases (Choice C) is not the immediate priority in this scenario and would typically be ordered by the healthcare provider based on the client's condition and response to initial interventions.

3. The Token Economy is a type of therapy that focuses on:

• A. play therapy
• B. behavior modification
• C. milieu therapy
• D. associative

Correct answer: B

Rationale: The correct answer is 'behavior modification.' The Token Economy is a form of behavior modification that involves providing positive reinforcement in the form of tokens or rewards for desired behaviors. This approach aims to increase the occurrence of positive behaviors by rewarding them. Play therapy (choice A) focuses on using play as a medium for therapeutic communication, not specifically behavior modification. Milieu therapy (choice C) involves shaping the environment to promote desired behaviors but is not the primary focus of the Token Economy. 'Associative' (choice D) is not directly related to the Token Economy or its focus on behavior modification, making it an incorrect choice.

4. The ethical principle of keeping professional promises or obligations is:

• A. veracity
• B. autonomy
• C. fidelity
• D. beneficence

Correct answer: C

Rationale: The correct answer is fidelity. Fidelity is the ethical principle that refers to keeping professional promises or obligations. Veracity, however, relates to truth-telling. Autonomy is about client self-determination and decision-making. Beneficence, on the other hand, involves doing good and is crucial in the provision of nursing care.

5. A 60-year-old widower is hospitalized after complaining of difficulty sleeping, extreme apprehension, shortness of breath, and a sense of impending doom. What is the best response by the nurse?

• A. "You have nothing to worry about. You are in a safe place. Try to relax."?
• B. "Has anything happened recently or in the past that might have triggered these feelings?"?
• C. "We have given you a medication that helps to decrease feelings of anxiety."?
• D. "Take some deep breaths and try to calm down."?

Correct answer: B

Rationale: Choice B is the best response as it shows empathy, acknowledges the patient's feelings, and opens the door for discussion about potential triggers for anxiety. This approach helps the patient explore the root cause of his anxiety and provides an opportunity for therapeutic communication. Choice A dismisses the patient's feelings and offers false reassurance, which may not address the underlying issue. Choices C and D do not encourage the patient to express his emotions or delve into the reasons behind his anxiety, hindering the therapeutic process.

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