Nursing Elites

1. A client with blood type AB negative delivers a newborn with blood type A positive. The cord blood reveals a positive indirect Coombs test. Which is the implication of this finding?

• A. The newborn is infected with an infectious blood-borne disease
• B. The newborn needs phototherapy for physiologic jaundice
• C. The mother's Rh antibodies are present in the neonatal blood
• D. The mother no longer needs Rho immune globulin injections

Correct answer: C

Rationale: A positive indirect Coombs test indicates that the mother's Rh antibodies have crossed the placenta and are present in the neonatal blood, which can lead to hemolytic disease of the newborn. This finding necessitates close monitoring and potential intervention. Choice A is incorrect because a positive Coombs test does not indicate an infectious blood-borne disease. Choice B is incorrect as phototherapy for physiologic jaundice is not related to a positive Coombs test result. Choice D is incorrect because a positive Coombs test does not indicate that the mother no longer needs Rho immune globulin injections; in fact, it suggests a need for further management to prevent hemolytic disease of the newborn.

2. The nurse and unlicensed assistive personnel (UAP) are providing care for a client who exhibits signs of neglect syndrome following a stroke affecting the right hemisphere. What action should the nurse implement?

• A. Demonstrate to the UAP how to approach the client from the client's left side
• B. Ask the UAP to leave the room and assess the client's body for bruising
• C. Carefully observe the interaction between the client and family members
• D. Instruct the UAP to protect the client's left side when transferring to a chair

Correct answer: A

Rationale: The correct action for the nurse to implement is to demonstrate to the UAP how to approach the client from the client's left side. Approaching the client from the neglected side (left side) can help in retraining the brain and improving awareness of the affected side, which is crucial in the management of neglect syndrome. Choice B is incorrect as assessing the client's body for bruising is not directly related to managing neglect syndrome. Choice C is incorrect as observing the interaction between the client and family members does not address the specific intervention needed for neglect syndrome. Choice D is incorrect because protecting the client's left side when transferring to a chair does not actively involve retraining the brain and improving awareness of the neglected side, which is the primary goal in managing neglect syndrome.

3. What information should the PN collect during the admission assessment of a terminally ill client to an acute care facility?

• A. Name of the funeral home to contact
• B. Client's wishes regarding organ donation
• C. Contact information for the client's next of kin
• D. Health care proxy information

Correct answer: B

Rationale: Correct Answer: B. Understanding the client's wishes regarding organ donation is crucial as it aligns with end-of-life care preferences and ensures that the client's decisions are respected. While obtaining the name of a funeral home (Choice A) may be necessary, it is not typically part of the initial admission assessment. Contact information for the client's next of kin (Choice C) is important for communication but may not be directly related to the client's immediate end-of-life wishes. Health care proxy information (Choice D) is vital for decision-making if the client becomes incapacitated but may not be the primary focus during the initial admission assessment.

4. The client diagnosed with HIV is taught by the nurse that the condition is transmitted through

• A. the infection passed from a mother to her baby
• B. Tears
• C. human bites
• D. insect bites

Correct answer: A

Rationale: HIV can be transmitted from a mother to her baby during childbirth or breastfeeding, making choice A the correct answer. Tears, human bites, and insect bites are not common modes of HIV transmission. While human bites can potentially transmit the virus, it is less common compared to mother-to-child transmission.

5. A client has a prescription for a transcutaneous electrical nerve stimulator (TENS) unit for pain management during the postoperative period following a lumbar laminectomy. Which information should the PN reinforce about the action of the adjuvant pain modality?

• A. The discharge of electricity will distract the client's focus from the pain.
• B. An infusion of medication into the spinal canal will block pain perception.
• C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus.
• D. A mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain.

Correct answer: D

Rationale: The TENS unit works by providing a mild electrical stimulus to the skin, which helps to 'close the gate' on pain signals, reducing the perception of pain. Choice A is incorrect because distraction is not the primary mechanism of action for TENS. Choice B is incorrect as it describes a different method of pain management involving medication infusion into the spinal canal. Choice C is incorrect as it inaccurately describes the location of pain perception modulation by the TENS unit.

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