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. A nurse is supervising a new nursing graduate in various procedures. Which action by the new nursing graduate constitutes a negligent act?

• A. Giving a verbal report to the nurse on the oncoming shift
• B. Checking neurological signs in a client with a head injury
• C. Contacting a healthcare provider about a change in a client's blood pressure
• D. Using clean gloves to change a gastrostomy tube dressing

Correct answer: D

Rationale: Negligent acts in nursing include various errors that can harm the client, such as medication errors, intravenous therapy errors, burns, falls, failure to use aseptic technique, failure to provide adequate monitoring, and failure to report significant changes in a client's condition. In this scenario, using clean gloves to change a gastrostomy tube dressing is a negligent act because sterile gloves should be used when changing a dressing over broken skin. Choices A, B, and C are not negligent acts as they involve appropriate nursing actions: giving a verbal report, checking neurological signs, and contacting a healthcare provider about a change in a client's blood pressure.

3. Which of the following is not an indication for pelvic ultrasonography?

• A. to measure uterine size
• B. to detect multiple pregnancies
• C. to measure renal size
• D. to detect foreign bodies

Correct answer: C

Rationale: Pelvic ultrasonography is commonly used to assess various conditions. Choices A, B, and D are all valid reasons for performing pelvic ultrasonography. Measuring uterine size helps evaluate conditions like fibroids, while detecting multiple pregnancies is essential for prenatal care. Furthermore, identifying foreign bodies can aid in diagnosing certain conditions. However, assessing renal size is typically not a primary reason for pelvic ultrasonography, making choice C the correct answer.

4. Which of these clients should the LPN/LVN see first?

• A. a client with a newly placed NG tube who is complaining of pain around the face and a plugged nose
• B. a post-op prostatectomy client who complains of bladder spasms and blood in his foley bag
• C. a client in an arm cast who is 2 days post-op and reports feelings of numbness and tingling in her affected arm
• D. a client newly diagnosed with Hepatitis A who reports stomach pain and itchy skin

Correct answer: C

Rationale: Numbness and tingling hours or days after a cast is applied may indicate compartment syndrome and should be reported to a medical provider right away. This is a potential emergency situation that requires immediate attention to prevent complications. The other options present expected or typical symptoms related to their diagnosis, which do not require immediate intervention. Complaints related to a newly placed NG tube such as pain around the face and a plugged nose may require assessment and intervention but are not as urgent as potential compartment syndrome. Bladder spasms and blood in the foley bag post-prostatectomy are common postoperative issues that can be addressed after the client in the arm cast with potential compartment syndrome is seen. Stomach pain and itchy skin in a client with Hepatitis A are common symptoms of the condition and do not indicate an emergency situation.

5. Which of the following are antiviral drug classes used in the treatment of HIV/AIDS?

• A. Nucleoside reverse transcriptase inhibitors
• B. Protease inhibitors
• C. HIV fusion inhibitors
• D. All of the above

Correct answer: D

Rationale: The correct answer is 'All of the above.' Nucleoside reverse transcriptase inhibitors inhibit the enzyme reverse transcriptase, protease inhibitors block the activity of the HIV-1 protease enzyme, and HIV fusion inhibitors prevent HIV from entering human cells. Therefore, all the choices provided are valid antiviral drug classes for managing HIV/AIDS. Nucleoside reverse transcriptase inhibitors, protease inhibitors, and HIV fusion inhibitors play crucial roles in combating the virus at different stages. Nucleoside reverse transcriptase inhibitors target an early stage, protease inhibitors act on a later stage, and HIV fusion inhibitors prevent viral entry. Thus, 'All of the above' is the correct and comprehensive answer encompassing different mechanisms of action in managing HIV/AIDS.

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