Nursing Elites

1. A client with brain cancer is transferring to hospice care. The client's son tells the nurse, 'I don’t know what to tell my dad if he asks how he is going to die.' Which of the following is an appropriate response by the nurse?

• A. “Let’s talk more about your dad’s condition.”
• B. “The social worker will help you answer those questions.”
• C. “I think that you should discuss this with the hospice nurse.”
• D. “Try to help your dad enjoy this time as much as he can.”

Correct answer: D

Rationale: Choosing option D, 'Try to help your dad enjoy this time as much as he can,' is the most appropriate response by the nurse. This response shows empathy and compassion towards the client and their family during this difficult transition. The focus on supporting the client in enjoying their remaining time reflects a holistic approach to care. Options A, B, and C are not the best responses in this situation. Option A could lead to unnecessary details that might be overwhelming for the family. Option B shifts the responsibility to the social worker without providing immediate support. Option C deflects the son's concerns to another healthcare professional when emotional support is needed.

2. A client has a new prescription for a home oxygen concentrator. Which of the following instructions should the nurse provide to the client and their family?

• A. Check the cord routinely for frays or tearing
• B. Use oxygen around open flames
• C. Store oxygen concentrator in a closet
• D. Wear synthetic clothing to prevent static electricity

Correct answer: A

Rationale: The correct answer is to instruct the client and their family to check the cord routinely for frays or tearing. This is crucial to ensure the safety and proper function of the oxygen concentrator. Choice B is incorrect because oxygen should never be used around open flames due to the risk of fire. Choice C is also incorrect as oxygen cylinders or concentrators should not be stored in a closet due to ventilation and safety concerns. Choice D is incorrect because synthetic clothing can generate static electricity, which could pose a risk around oxygen equipment.

3. A nurse at a provider’s office is discussing routine screenings with a 45-year-old female client who has no specific family history of cancer or diabetes mellitus. Which of the following client statements indicates that the client understands how to proceed?

• A. “So I don’t need the colon cancer screening for another 2 or 3 years.”
• B. “For now, I should continue to have a mammogram each year.”
• C. “Because the doctor just performed a Pap smear, I’ll return next year for another one.”
• D. “I had my glucose test last year, so I won’t need it again for 4 years.”

Correct answer: B

Rationale: The correct answer is B. Mammograms are recommended annually for women starting at age 40 or 45. This statement aligns with current guidelines for breast cancer screening in women without specific risk factors. Choice A is incorrect because colon cancer screenings are typically recommended at different intervals. Choice C is incorrect as Pap smears are usually done every 3-5 years based on age and risk factors. Choice D is incorrect because glucose testing is usually recommended more frequently, especially for individuals at risk for diabetes mellitus.

4. While interviewing a client, the nurse records the assessment in the electronic health record. Which statement is most accurate regarding electronic documentation during an interview?

• A. The client's comfort level is increased when the nurse maintains eye contact while typing notes into the record
• B. The interview process is hindered by electronic documentation and may disrupt the flow of conversation
• C. The nurse has limited ability to observe nonverbal communication while entering the assessment electronically
• D. Completing the electronic record during an interview is optional and not a legal obligation of the examining nurse

Correct answer: C

Rationale: The most accurate statement is that the nurse has a limited ability to observe nonverbal communication while entering the assessment electronically. This is because the nurse's focus is on typing or inputting data, which may lead to missing important nonverbal cues from the client. Choices A and B are incorrect as they do not address the limitation of observing nonverbal cues. Choice A is incorrect because breaking eye contact to type notes may hinder the client's comfort level. Choice B is incorrect because it states that electronic documentation enhances the interview process, which may not always be the case. Choice D is incorrect as completing the electronic record during an interview is typically a standard practice but not a legal obligation.

5. During a neurologic examination, which assessment should a nurse perform to test a client's balance?

• A. Romberg test
• B. Heel-to-toe walk
• C. Snellen test
• D. Spinal accessory function

Correct answer: A

Rationale: The Romberg test is used to assess a client's balance by evaluating their ability to maintain a steady posture with eyes closed. The heel-to-toe walk is another assessment that tests balance by assessing gait and coordination. The Snellen test is used to assess visual acuity and is unrelated to balance. Testing spinal accessory function involves assessing the movement of the head and shoulders and is not directly related to balance assessment.

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