Nursing Elites

1. A nurse is caring for a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue the client's feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make?

• A. You should contact the provider about your wishes for your family member.
• B. We'll need to have the nursing supervisor review the client's advance directives.
• C. You should speak with the facility's ethics committee about your concerns.
• D. As the health care surrogate, the client's partner can make this decision.

Correct answer: D

Rationale: The correct response is D because the health care surrogate, as designated by the client, has the legal authority to make healthcare decisions on behalf of the client when they are unable to do so. This authority includes decisions about treatment continuation or withdrawal. Option A is incorrect as the family member's wishes do not override the legal authority of the health care surrogate. Option B is not the most appropriate action in this situation as the advance directives are already clear by the designation of a health care surrogate. Option C is not necessary at this stage since the health care surrogate can make the decision without involving the ethics committee.

2. A nurse in a long-term care facility is caring for a client who reports the AP repositioned him in bed using excessive force. Which of the following actions should the nurse take?

• A. Document in the client's chart that an incident report has been filed.
• B. Contact the nurse manager.
• C. Reassure the client that the staff is well trained.
• D. Call risk management to interview the client.

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to contact the nurse manager. By doing so, the nurse can escalate the issue appropriately, ensuring that the incident is addressed and necessary actions are taken. Documenting in the client's chart that an incident report has been filed (Choice A) may be necessary but should not be the first step. Reassuring the client that the staff is well trained (Choice C) does not address the client's concern and the need for intervention. Calling risk management to interview the client (Choice D) may be premature at this stage and should be handled by the nurse manager first.

3. What is the significance of patient advocacy in nursing?

• A. Prioritizing the needs of the healthcare team over the patient
• B. Ensuring that patients' rights and preferences are respected
• C. Limiting patient autonomy
• D. Focusing solely on clinical procedures

Correct answer: B

Rationale: Patient advocacy in nursing entails ensuring that patients' rights and preferences are respected. This involves advocating for the patients' best interests, supporting informed decision-making, and safeguarding their autonomy. Choice A is incorrect because patient advocacy focuses on the patient's needs, not the healthcare team's. Choice C is incorrect as patient advocacy aims to empower patients and enhance their autonomy rather than limiting it. Choice D is incorrect since patient advocacy goes beyond clinical procedures to encompass holistic care that addresses the patients' preferences and rights.

4. Which of the following best describes evidence-based practice?

• A. Using outdated research
• B. Relying on personal experience alone
• C. Integrating clinical expertise with the best available evidence
• D. Disregarding patient preferences

Correct answer: C

Rationale: Evidence-based practice involves integrating clinical expertise with the best available evidence to make informed decisions about patient care. Choice A is incorrect as evidence-based practice relies on current and relevant research. Choice B is incorrect as it emphasizes the importance of not relying solely on personal experience. Choice D is incorrect as patient preferences play a significant role in evidence-based practice.

5. Rotating injection sites when administering insulin prevents which of the following complications?

• A. Insulin edema
• B. Insulin lipodystrophy
• C. Insulin resistance
• D. Systemic allergic reactions

Correct answer: B

Rationale: Rotating injection sites when administering insulin helps prevent insulin lipodystrophy, which is the abnormal distribution of fat at injection sites. Insulin edema (choice A) is not prevented by rotating injection sites; it is characterized by swelling at the site of insulin injection due to increased capillary permeability. Insulin resistance (choice C) is a condition where the body's cells become less responsive to insulin, and rotating injection sites does not directly prevent this. Systemic allergic reactions (choice D) are not specifically prevented by rotating injection sites; they are related to an allergic response to insulin.

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