Nursing Elites

1. A nurse is planning to administer an oral antibiotic to a client with a communicable disease. The client refuses the medication and tells the nurse that the medication causes abdominal cramping. The nurse responds, 'The medication is needed to prevent the spread of infection, and if you don't take it orally I will have to give it to you in an intramuscular injection.' Which statement accurately describes the nurse's response to the client?

• A. The nurse is justified in administering the medication by way of the intramuscular route because the client has a communicable disease.
• B. The nurse could be charged with assault.
• C. Assault is an intentional threat to bring about harmful or offensive contact. If a nurse threatens to give a client a medication that the client refuses or threatens to give a client an injection without the client's consent, the nurse may be charged with assault. Therefore, the nurse is not justified in administering the medication. Battery is any intentional touching without the client's consent.
• D. The nurse will be justified in administering the medication by the intramuscular route once a prescription has been obtained from the health care provider.

Correct answer: C

Rationale: The correct answer explains the concept of assault, which is an intentional threat to bring about harmful or offensive contact. In the scenario provided, the nurse's statement about administering the medication via an intramuscular injection without the client's consent constitutes a threat, potentially falling under the definition of assault. Choice A is incorrect because the nurse's action is not automatically justified solely by the client having a communicable disease. Choice D is also incorrect because even with a prescription, the nurse cannot administer the medication without the client's consent. Choice C provides a detailed explanation distinguishing assault from battery, which helps in understanding the legal implications of the nurse's response in this situation.

2. Which of the following tasks are appropriate for an LPN to perform?

• A. Adjusting the cervical traction device of a 68-year-old client as instructed by the charge nurse.
• B. performing operation on a woman in labour
• C. Assessing a 36-year-old man newly admitted for chest pain.
• D. Obtaining an occult blood sample from a 16-year-old client with ulcerative colitis.

Correct answer: D

Rationale: Tasks appropriate for an LPN to perform include teaching, obtaining samples, and documenting. LPNs can educate clients on care practices, such as teaching a new mother how to care for her baby. Obtaining samples, like an occult blood sample, falls within the scope of an LPN's responsibilities. Assessments, especially initial assessments, should be conducted by a registered nurse or physician, making option C incorrect. Adjusting devices like a cervical traction device should be done based on direct orders from prescribing providers, not charge nurses, making option A inappropriate for an LPN's role.

3. What can happen if a restraint is attached to a side rail or other movable part of the bed?

• A. Do nothing to the client.
• B. Injure the client if the rail or bed is moved.
• C. Help the client stay in the bed without falling out.
• D. Help the client with better posture.

Correct answer: B

Rationale: Attaching a restraint to a movable part of the bed can lead to client injury if that part of the bed is moved before releasing restraints. This could result in the client getting caught or trapped, possibly causing harm. Choices C and D are incorrect because attaching restraints to movable parts of the bed is not intended to help the client stay in bed or improve posture; rather, it poses a risk of injury. Choice A is incorrect as it does not address the potential harm associated with using restraints on movable parts of the bed.

4. The nurse and a colleague are on the elevator after their shift, and they hear a group of healthcare providers discussing a recent client scenario. Which client right might be breached?

• A. right to refuse treatment
• B. right to continuity of care
• C. right to confidentiality
• D. right to reasonable responses to requests

Correct answer: C

Rationale: The right to confidentiality of client information might be breached when client care situations are discussed in public areas or without regard to maintaining the information as private and confidential. In this scenario, the conversation on the elevator could lead to a breach of the client's right to confidentiality. The other options, such as the right to refuse treatment, right to continuity of care, and right to reasonable responses to requests, are not being breached in this instance, making them incorrect choices.

5. Which of the following microorganisms are considered normal body flora?

• A. staphylococcus on the skin
• B. streptococcus in the nares
• C. candida albicans in the vagina
• D. pseudomonas in the blood

Correct answer: A

Rationale: Staphylococcus is considered normal body flora as it is commonly found on the skin, being a part of the normal microbiota. While streptococcus in the nares can be part of the normal flora of the upper respiratory tract, it is not as common or as widespread as staphylococcus on the skin. Candida albicans in the vagina is not considered normal flora; it is a common opportunistic pathogen in the vagina. Pseudomonas in the blood is also not considered normal body flora; pseudomonas is not typically found in the blood as part of the normal microbiota.

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