Nursing Elites

1. 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.

2. A healthcare provider is reviewing the medical record of a client who has a new prescription for clozapine. Which of the following findings indicates a contraindication to clozapine?

• A. Fasting blood glucose of 120 mg/dL
• B. Asthma
• C. Hypertension
• D. WBC count of 3,300/mm3

Correct answer: D

Rationale: A low WBC count (3,300/mm3) is a contraindication to clozapine because this medication can cause severe neutropenia. Neutropenia is a significant reduction in white blood cell count, increasing the risk of infections. Elevated fasting blood glucose, asthma, and hypertension are not direct contraindications to clozapine.

3. A patient prescribed warfarin is being taught about dietary restrictions by a healthcare provider. Which of the following foods should the patient be instructed to limit?

• A. Bananas
• B. Spinach
• C. Potatoes
• D. Apples

Correct answer: B

Rationale: The correct answer is B: Spinach. Spinach is high in vitamin K, which can interfere with the effectiveness of warfarin, an anticoagulant medication. Patients taking warfarin should limit foods high in vitamin K to maintain the medication's effectiveness and consistent dosage. Bananas, potatoes, and apples are not high in vitamin K and do not typically interfere with warfarin therapy.

4. When working with a client who does not speak the same language, which of the following actions should the nurse take?

• A. Speak directly to the interpreter
• B. Use family members to translate
• C. Speak directly to the patient
• D. Use medical jargon

Correct answer: C

Rationale: When caring for a client who does not speak the same language, it is essential for the nurse to speak directly to the patient. This approach helps maintain rapport, establishes a trusting relationship, and ensures better communication. Speaking to the interpreter instead of the patient can lead to misunderstandings and hinder the therapeutic relationship. Using family members to translate is not recommended as they may not provide accurate or confidential information. Lastly, using medical jargon can further complicate communication and may not be understood by the patient.

5. During an initial visit, a home health nurse is assessing a client who has cultural beliefs different from their own. Which of the following questions should the nurse ask to determine the client's beliefs about environmental control?

• A. Do you spend more time thinking about the past, present, or future?
• B. Who makes most of the decisions in your family group?
• C. What do you think you can do to affect your health status?
• D. Can you list any diseases that your parents or siblings have had?

Correct answer: C

Rationale: The correct question to ask in this scenario is: 'What do you think you can do to affect your health status?' This question directly addresses the client's beliefs about their ability to control their health and reflects their beliefs about environmental control. Choices A, B, and D do not directly relate to assessing the client's beliefs about environmental control. Choice A focuses on time orientation, choice B pertains to family decision-making dynamics, and choice D is related to family medical history, which are not directly relevant to understanding the client's beliefs about environmental control.

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