Nursing Elites

1. A client asks a nurse about the purpose of advance directives.

• A. Indicate a form of treatment a client is willing to accept.
• B. Specify the client's preferred hospital for treatment.
• C. Determine the client's daily medication schedule.
• D. Outline the client's financial status and insurance coverage.

Correct answer: A

Rationale: The correct answer is A: Advance directives serve to indicate the forms of medical treatment a client wishes to receive or decline in the event they are unable to communicate their preferences. This legal document allows individuals to make decisions about their future healthcare. Choice B is incorrect as advance directives do not specify the client's preferred hospital for treatment. Choice C is incorrect as advance directives do not determine the client's daily medication schedule; this is typically addressed in a medication administration record. Choice D is incorrect as advance directives do not outline the client's financial status and insurance coverage, but rather focus on healthcare treatment preferences.

2. How can self-injury be prevented when lifting a bedside cabinet?

• A. Standing close to the cabinet when lifting.
• B. Bending at the waist when lifting.
• C. Twisting while lifting to balance the load.
• D. Lifting with a quick motion.

Correct answer: A

Rationale: The correct way to prevent self-injury when lifting a bedside cabinet is by standing close to the cabinet. By standing close, the individual can maintain better control and balance while lifting, reducing the risk of injury. Bending at the waist when lifting (choice B) can strain the back and lead to injury. Twisting while lifting (choice C) can also cause strain and imbalance. Lifting with a quick motion (choice D) can increase the risk of injury due to lack of control and improper body mechanics.

3. When caring for a client at the end of life, which statement by the client’s partner reflects effective coping?

• A. I am relying on support from our family during this time.
• B. I am feeling overwhelmed but don’t want to talk about it.
• C. I am managing everything on my own without help.
• D. I prefer to stay alone with my partner.

Correct answer: A

Rationale: The correct answer is A: 'I am relying on support from our family during this time.' When a client is at the end of life, relying on support from family can be an effective coping mechanism. It allows the partner to share the emotional burden, seek comfort, and prevent feelings of isolation. Choice B reflects a reluctance to express feelings, which can hinder coping mechanisms by internalizing stress. Choice C suggests handling everything alone, which can lead to burnout and emotional strain due to the overwhelming responsibilities. Choice D, preferring to stay alone with the partner, may limit access to external support that could provide additional emotional and practical assistance during this challenging time, making it a less effective coping strategy.

4. A client with a history of heart failure presents with increased shortness of breath and swelling in the legs. What is the most important assessment for the LPN/LVN to perform?

• A. Monitor the client's oxygen saturation level.
• B. Assess the client's apical pulse.
• C. Check for jugular vein distention.
• D. Measure the client's urine output.

Correct answer: C

Rationale: Checking for jugular vein distention is crucial in assessing fluid overload in clients with heart failure. Jugular vein distention indicates increased central venous pressure, which can be a sign of worsening heart failure. Monitoring oxygen saturation (Choice A) is important but may not provide immediate information on fluid status. Assessing the apical pulse (Choice B) is relevant for monitoring heart rate but may not directly indicate fluid overload. Measuring urine output (Choice D) is essential for assessing renal function and fluid balance but does not provide immediate information on fluid overload in this scenario.

5. Seconal 0.1 gram PRN at bedtime is prescribed to a client for rest. The scored tablets are labeled 1.5 grains per tablet. How many tablets should the LPN/LVN plan to administer?

• A. 0.5 tablet
• B. 1 tablet
• C. 1.5 tablets
• D. 2 tablets

Correct answer: B

Rationale: To calculate the number of tablets needed, convert the prescribed dose of Seconal from grams to grains. Since 1 gram is equal to approximately 15.43 grains, 0.1 gram is roughly 1.543 grains. Given that each tablet contains 1.5 grains, administering 1 tablet (which is slightly more than the 1.543 grains needed) provides the correct dose of Seconal. Therefore, the LPN/LVN should plan to administer 1 tablet. Choice A (0.5 tablet) is incorrect as it would provide less than the required dose. Choice C (1.5 tablets) and Choice D (2 tablets) are incorrect as they would exceed the necessary dosage.

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