Nursing Elites

1. When planning play activities for a hospitalized school-age child, a nurse uses Erikson's theory of psychosocial development to select an appropriate activity. The nurse selects an activity that will assist the child in developing which developmental goal?

• A. A sense of industry
• B. Autonomy
• C. A sense of trust
• D. Initiative

Correct answer: C

Rationale: The correct answer is 'A sense of industry.' According to Erikson, the central task of the school-age years is the development of a sense of industry. During this stage, children engage in activities like schoolwork, crafts, chores, hobbies, and sports to develop a sense of competence and productivity. The development of trust is the primary task of infancy, autonomy is the task of toddlerhood, and initiative is the task of the preschool years. Therefore, in this scenario, focusing on fostering a sense of industry aligns with the developmental goals of a school-age child.

2. All of the following tasks could be delegated to a nursing assistant or unlicensed assistive personnel (UAP) except:

• A. monitoring intravenous infusion
• B. assisting a client to the bathroom
• C. offering fluid intake every 1-2 hours
• D. monitoring/recording the amount of fluid taken

Correct answer: A

Rationale: Monitoring an intravenous infusion involves assessing for complications, adjusting the flow rate, and monitoring the client's response, which requires the knowledge and skills of a licensed nurse (RN or LPN). Tasks that can be delegated to nursing assistants or unlicensed assistive personnel include assisting a client to the bathroom, offering fluids, and recording fluid intake. These activities are within the scope of practice for UAPs as they do not involve the specialized knowledge and training needed for intravenous infusion monitoring.

3. The client is going for surgery and mentions their religious objection to blood transfusions. Which of the following responses would be most appropriate?

• A. "I can ask pastoral care to send someone to speak with you about this concern since it would not be safe to refuse a blood transfusion."?
• B. "I understand, and you have the right to refuse blood transfusions."?
• C. "While I understand, if there is excessive bleeding during surgery, we may need to transfuse blood to stabilize you."?
• D. "I have received a blood transfusion before, and I do not think you understand the risks versus the benefits of refusing this."?

Correct answer: B

Rationale: The most appropriate response is, '"I understand, and you have the right to refuse blood transfusions."? This answer shows respect for the client's autonomy and religious beliefs. It is crucial for healthcare providers to acknowledge and support a patient's decision-making regarding their care, even if it conflicts with medical advice. Option A is not ideal as it might seem dismissive of the client's beliefs. Option C introduces a potential negative outcome of refusing a blood transfusion, which could induce fear or coercion. Option D is inappropriate because it implies judgment and does not uphold the client's autonomy.

4. Under what circumstances can an individual receive medical care without giving informed consent?

• A. when the durable power of attorney for health care is not available
• B. in an emergency, life-or-death situation
• C. when the physician is not available for discussion with the client
• D. when they (clients) are not able to speak for themselves

Correct answer: B

Rationale: An individual may receive medical care without giving informed consent in an emergency, life-or-death situation. This exception allows healthcare providers to provide immediate treatment to save a person's life or prevent serious harm when time is of the essence. Choices A, C, and D are incorrect because in all other situations, informed consent is required. The durable power of attorney for health care should be involved if available, the physician should have a discussion with the client in non-life-threatening situations, and in cases where clients are unable to speak for themselves, their designated representative or responsible party should be involved in the consent process.

5. In an obstetrical emergency, which of the following actions should the nurse perform first after the baby delivers?

• A. Place extra padding under the mother to absorb blood from the delivery.
• B. Cut the umbilical cord using sterile scissors.
• C. Suction the baby's mouth and nose.
• D. Wrap the baby in a clean blanket to preserve warmth.

Correct answer: C

Rationale: In an obstetrical emergency, the immediate action the nurse should take after the baby delivers is to suction the baby's mouth and nose to ensure the infant can breathe properly. This helps clear any potential obstructions and establish a clear airway. Cutting the umbilical cord (Choice B) and wrapping the baby in a clean blanket (Choice D) are important steps but should come after ensuring the baby's airway is clear. Placing extra padding under the mother (Choice A) is not a priority in this emergency situation as the focus should be on the baby's immediate needs for breathing and airway clearance.

Similar Questions