Nursing Elites

1. A confused client has been placed in physical restraints by order of the healthcare provider. Which task could be assigned to an unlicensed assistive personnel (UAP)?

• A. Assist the client with activities of daily living
• B. Monitor the client's physical safety
• C. Evaluate for basic comfort needs
• D. Document mental status and muscle strength

Correct answer: A

Rationale: The correct answer is A: 'Assist the client with activities of daily living.' Unlicensed assistive personnel (UAP) can help clients with activities of daily living, such as feeding, bathing, and dressing. This task is appropriate for UAP as it does not require professional judgment. Choices B, C, and D involve monitoring safety, evaluating needs, and documenting assessments, which require a licensed nurse's professional judgment and expertise.

2. As a client who is terminally ill has been receiving high doses of an opioid analgesic for the past month and becomes unresponsive to verbal stimuli as death approaches, what orders would the nurse expect from the healthcare provider?

• A. Decrease the analgesic dosage by half
• B. Discontinue the analgesic
• C. Continue the same analgesic dosage
• D. Prescribe a less potent drug

Correct answer: C

Rationale: Continuing the same dosage of analgesic is appropriate to manage pain effectively as death nears and the client becomes unresponsive. The primary goal of palliative care in end-of-life situations is to ensure comfort, regardless of the client's level of consciousness. Decreasing the analgesic dosage or discontinuing it could lead to inadequate pain relief, which goes against the principles of palliative care. Prescribing a less potent drug may also compromise pain management in this critical stage. Therefore, maintaining the same analgesic dosage is the most appropriate action to provide comfort and alleviate suffering.

3. What are the sources of information about the family?

• A. Interview results with members of the family
• B. Family folder
• C. Actual observation of the family situation
• D. All these sources of information

Correct answer: D

Rationale: The correct answer is D because all the listed sources - interview results with family members, family folder, and actual observation of the family situation - provide comprehensive information about the family. Choice A alone (interview results) might not capture the complete picture of the family, as it may be biased or limited. Choice B (family folder) could contain valuable information but might not be up to date or comprehensive. Choice C (actual observation) is essential to understand the family dynamics, but it alone may not provide all the necessary information. Therefore, the combination of all these sources (D) is needed for a thorough understanding of the family.

4. A client with terminal cancer is experiencing severe pain. The nurse plans to implement which of the following pain management strategies?

• A. Administer analgesics on a fixed schedule
• B. Administer analgesics only when the client requests
• C. Use non-pharmacological methods only
• D. Increase the dose of analgesics when the client complains of pain

Correct answer: A

Rationale: Administering analgesics on a fixed schedule is the most appropriate pain management strategy for a client with terminal cancer experiencing severe pain. This approach ensures consistent pain control and helps prevent breakthrough pain. Administering analgesics only when the client requests (Choice B) may lead to uncontrolled pain as the client may delay requesting medication until the pain becomes unbearable. Using non-pharmacological methods only (Choice C) may not provide adequate pain relief for a client experiencing severe pain. Increasing the dose of analgesics when the client complains of pain (Choice D) may result in inconsistent pain control and could lead to potential overdose or adverse effects.

5. Which of the following is the earliest school of nursing in the country?

• A. Iloilo Mission Hospital School of Nursing
• B. St. Paul's Hospital School of Nursing
• C. University of Sto. Tomas College of Nursing
• D. Manila Central University

Correct answer: A

Rationale: The correct answer is A: Iloilo Mission Hospital School of Nursing. This nursing school holds the distinction of being the earliest in the Philippines. St. Paul's Hospital School of Nursing, University of Sto. Tomas College of Nursing, and Manila Central University are not the oldest nursing schools in the country, making them incorrect choices.

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