Nursing Elites

1. While preparing a client for a bronchoscopy, a nurse notes that the client is wearing a gold necklace. What should the nurse do to safeguard the client's necklace?

• A. Ask the client for permission to lock the necklace in the hospital safe
• B. Ask the client to remove the necklace and place it in the top drawer of the bedside table
• C. Ask the client whether the necklace is gold
• D. Ask the client to sign a release to free the hospital of responsibility if the necklace is damaged or lost during the procedure

Correct answer: A

Rationale: When a client has valuables such as jewelry, the nurse should ensure their safekeeping. It is appropriate for the nurse to ask the client for permission to lock the necklace in the hospital safe to prevent loss or damage. This option prioritizes the security of the necklace while allowing the client to make an informed decision. Asking the client to sign a release form does not guarantee the necklace's safety; it only releases the hospital from liability. Placing the necklace in a bedside table drawer does not provide adequate security as it is not as secure as a hospital safe. Inquiring whether the necklace is gold is irrelevant to safeguarding the jewelry during the procedure, as the primary concern is its safekeeping.

2. A client admitted to the hospital has a do-not-resuscitate (DNR) order in his medical record. The nurse understands which information about DNR orders?

• A. The only individuals who may change the DNR order are healthcare providers
• B. The DNR order can be changed if the client's condition warrants it
• C. The DNR order does not remain fixed for the duration of the client's hospitalization
• D. The DNR order requires frequent review as specified by state or agency policy

Correct answer: D

Rationale: The correct answer is that the DNR order requires frequent review as specified by state or agency policy. If the client's condition changes, the DNR order may need to be changed. For this reason, DNR orders require frequent review as specified by state or agency policy. A DNR order may be changed at any time and does not remain in effect for the duration of the client's hospitalization. The client's request regarding DNR status is the priority. Choice A is incorrect because healthcare providers, not just immediate family members, may change the DNR order based on the client's condition. Choice B is incorrect as DNR orders can be changed if the client's condition warrants it, not remaining unchanged. Choice C is incorrect as DNR orders are not fixed for the duration of hospitalization, they can be modified based on the client's needs.

3. The client has asked if you would be able to offer any alternative or complementary therapy during their hospitalization. Which of the following would be appropriate to suggest?

• A. Physical therapy
• B. Music therapy
• C. Psychiatric therapy
• D. Occupational therapy

Correct answer: B

Rationale: Music therapy is an appropriate suggestion as an alternative or complementary therapy during hospitalization. Music therapy can help improve the client's condition and comfort level by providing emotional support and reducing stress. Physical therapy and occupational therapy are crucial for rehabilitation and improving physical function, while psychiatric therapy focuses on mental health treatment. These therapies are essential components of care but are not typically considered alternative or complementary therapies in this context.

4. The client has a new prosthetic hip, and the nurse is repositioning them. Which position should be avoided to prevent injury to the new prosthetic hip?

• A. abduction of the hip
• B. adduction of the hip
• C. flexing the hip at 80° flexion
• D. flexing the hip at 90°

Correct answer: B

Rationale: The correct answer is 'adduction of the hip.' When a client has a new prosthetic hip, adduction (movement of the leg toward the midline of the body) should be avoided to prevent injury to the new prosthetic hip. Abduction (movement of the leg away from the midline) is typically allowed and may even be encouraged. Flexing the hip at certain degrees is acceptable, but adduction should be avoided to prevent complications or dislocation of the prosthetic hip. Therefore, options A, C, and D are incorrect because they do not pose a direct risk to the new prosthetic hip compared to adduction.

5. 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.

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