Nursing Elites

1. An elderly resident of a long-term care facility is no longer able to perform self-care and is becoming progressively weaker. The resident previously requested that no resuscitative efforts be performed, and the family requests hospice care. What action should the LPN/LVN implement first?

• A. Reaffirm the client's desire for no resuscitative efforts.
• B. Transfer the client to a hospice inpatient facility.
• C. Prepare the family for the client's impending death.
• D. Notify the healthcare provider of the family's request.

Correct answer: D

Rationale: The first action the LPN/LVN should implement is to notify the healthcare provider of the family's request. This is crucial to ensure that appropriate steps are taken to address the family's request for hospice care and to coordinate the necessary care for the resident. While reaffirming the client's desire for no resuscitative efforts is important, notifying the healthcare provider takes precedence in this situation. Transferring the client to a hospice inpatient facility and preparing the family for the client's impending death are significant actions but should be done after notifying the healthcare provider to ensure proper coordination of care.

2. A nurse is teaching the parents of a toddler about discipline. Which of the following actions should the nurse suggest?

• A. Establish consistent boundaries for the toddler.
• B. Place the toddler in a room with the door closed.
• C. Inform the toddler how you feel when he misbehaves.
• D. Use a favorite snack to reward the toddler.

Correct answer: A

Rationale: The correct answer is to establish consistent boundaries for the toddler. This approach helps toddlers understand expectations and promotes consistent behavior. Placing the toddler alone or using food rewards may not effectively teach discipline and could be inappropriate. Informing the toddler about feelings when misbehaving may not be developmentally appropriate for a toddler to understand the consequences of their actions.

3. A nurse at a clinic is collecting data about pain from a client who reports severe abdominal pain. The nurse asks the client if there have been any accompanying nausea and vomiting. Which of the following pain characteristics is the nurse attempting to determine?

• A. Presence of associated manifestations.
• B. Location of the pain
• C. Pain quality
• D. Aggravating and relieving factors

Correct answer: A

Rationale: The nurse is identifying associated manifestations like nausea and vomiting that may occur with the pain. The presence of associated manifestations helps in understanding the broader clinical picture and potential causes of the pain. Location refers to where the pain is felt, pain quality describes the nature of the pain, and aggravating and relieving factors relate to what makes the pain worse or better. In this scenario, the focus is on identifying additional symptoms that can provide important diagnostic clues.

4. A client with pneumonia is receiving antibiotic therapy. Which finding indicates that the treatment is effective?

• A. Decreased white blood cell count
• B. Decreased respiratory rate
• C. Increased breath sounds
• D. Increased heart rate

Correct answer: C

Rationale: The correct answer is C: Increased breath sounds. When a client with pneumonia is receiving antibiotic therapy, increased breath sounds indicate that the lungs are clearing and the pneumonia is resolving. This improvement in breath sounds suggests that the antibiotics are effectively treating the infection. Choices A, B, and D are incorrect because a decreased white blood cell count, decreased respiratory rate, and increased heart rate are not specific indicators of the effectiveness of antibiotic therapy in treating pneumonia. While these parameters may change in response to treatment, they do not directly reflect the resolution of the pneumonia infection.

5. The nurse in the emergency department observes a colleague viewing the electronic health record (EHR) of a client who holds an elected position in the community. The client is not a part of the colleague's assignment. Which action should the nurse implement?

• A. Communicate the colleague's actions to the unit charge nurse
• B. Send an email to facility administration reporting the action
• C. Write an anonymous complaint to a professional website
• D. Post a comment about the action on a staff discussion board

Correct answer: A

Rationale: Communicating the colleague's actions to the unit charge nurse is the most appropriate action to take in this scenario. Reporting to the charge nurse follows proper protocol and ensures privacy compliance. This option allows for addressing the issue internally within the healthcare setting, maintaining confidentiality, and following the chain of command. Sending an email to facility administration (Choice B) might be premature without internal investigation and could potentially bypass the immediate supervisor who is responsible for addressing such issues. Writing an anonymous complaint to a professional website (Choice C) and posting a comment about the action on a staff discussion board (Choice D) are not professional or effective ways to address the situation, as they do not ensure proper handling of the breach of privacy within the organization.

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