Nursing Elites

1. A client expresses concern about hair loss during chemotherapy. What should the nurse suggest?

• A. Encourage the client to cut their hair short before chemotherapy begins.
• B. Offer resources for wigs and head coverings.
• C. Assure the client that hair loss will be minimal.
• D. Ignore the client's concerns about hair loss.

Correct answer: B

Rationale: During chemotherapy, hair loss is a common side effect. Offering resources for wigs and head coverings can help the client cope with this change in appearance, maintain self-esteem, and feel more comfortable during the process. Encouraging the client to cut their hair short does not address the emotional impact of hair loss and may not be the client's preference. Assuring the client that hair loss will be minimal may provide false hope as significant hair loss is a common occurrence. Ignoring the client's concerns is not appropriate and goes against the principles of providing holistic and compassionate care.

2. A patient is at risk for impaired skin integrity. What is the priority intervention for the nurse?

• A. Turn and reposition the patient every 2 hours.
• B. Apply a moisture barrier to the patient's skin.
• C. Massage the patient's skin to promote circulation.
• D. Apply a heating pad to the patient's skin to increase blood flow.

Correct answer: A

Rationale: The correct answer is to turn and reposition the patient every 2 hours. This intervention is crucial in preventing pressure ulcers and maintaining skin integrity by relieving pressure on bony prominences. Applying a moisture barrier (Choice B) is important for moisture-associated skin damage but is not the priority in this case. Massaging the patient's skin (Choice C) can potentially cause friction and shear, increasing the risk of skin breakdown. Applying a heating pad (Choice D) can lead to burns or thermal injuries, exacerbating skin integrity issues.

3. A client with a do-not-resuscitate (DNR) order has requested resuscitation during a family visit. How should the nurse respond?

• A. Follow the client's wishes and start resuscitation.
• B. Explain that the DNR must be honored.
• C. Ignore the client's request.
• D. Consult with the family regarding the decision.

Correct answer: B

Rationale: The correct answer is B. Nurses have a legal and ethical obligation to honor a client's do-not-resuscitate (DNR) order, regardless of any request for resuscitation during a family visit. It is crucial for the nurse to explain to the client that the DNR order must be respected. Choice A is incorrect because starting resuscitation against the client's documented wishes goes against the principle of autonomy. Choice C is inappropriate as it disregards the client's autonomy and legal directives. Choice D is not the best option as the nurse should prioritize honoring the client's decision as per the DNR order.

4. A client who is 97 years old has successfully been treated for heart failure and is found not breathing. There is no DNR order in place. What should the nurse do?

• A. Notify the family and await further instructions.
• B. Initiate CPR and call for emergency assistance.
• C. Allow the family to make decisions about care.
• D. Follow the family's wishes and perform no interventions.

Correct answer: B

Rationale: In this scenario, with no DNR order in place and the client not breathing, the nurse should initiate CPR and call for emergency assistance. Option A is incorrect as immediate action is required in the absence of breathing. Option C is incorrect as the nurse should act promptly to provide life-saving measures. Option D is incorrect because the nurse's primary duty is to provide care in the absence of a directive preventing intervention.

5. A hospice nurse is providing teaching to a client who has a new diagnosis of a terminal illness and her family. Which of the following statements should the nurse include in the teaching?

• A. Hospice care focuses on providing comfort and symptom management.
• B. The provider will coordinate your health care needs while in hospice.
• C. You do not need to choose a family caregiver before being admitted into a hospice facility.
• D. Hospice care continues to help families with grief after a death occurs.

Correct answer: D

Rationale: The correct answer is D because hospice care provides ongoing support to families with grief even after a patient's death. Choice A is incorrect because hospice care focuses on providing comfort and symptom management rather than disease treatment and rehabilitation. Choice B is incorrect as the statement does not accurately reflect the role of a hospice provider. Choice C is incorrect; a family caregiver is not a prerequisite for admission into a hospice facility.

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