Nursing Elites

1. An LPN is tasked with checking the narcotic count on a medical-surgical unit. Which statement by the LPN requires further investigation?

• A. "I need a witness when I waste the leftover narcotics in the client's PCA pump."?
• B. "I am going to check the facility's policy for how to dispose of this controlled substance."?
• C. "I left the narcotics box unlocked after confirming the beginning of shift count was correct."?
• D. "The end of shift narcotics count is incorrect and needs to be reported."?

Correct answer: C

Rationale: The LPN's statement about leaving the narcotics box unlocked after confirming the beginning of shift count was correct requires further investigation. Narcotics should be locked and kept in a secure place during the shift to prevent unauthorized access and ensure patient safety. This statement raises concerns about medication security, which is critical in preventing diversion and ensuring patient safety. The other statements demonstrate appropriate actions: A) The LPN acknowledges the need for a witness when wasting leftover narcotics, ensuring proper documentation and accountability during medication waste. B) Checking the facility's policy for proper disposal of controlled substances shows awareness of regulatory compliance regarding controlled substances. D) Recognizing an incorrect end-of-shift narcotics count and planning to report it reflects the LPN's responsibility in maintaining accurate records and addressing discrepancies, which is essential for medication safety and accountability.

2. People who live in poverty are most likely to obtain health care from:

• A. their primary care physician (family doctor)
• B. a neighborhood clinic
• C. specialists
• D. Emergency Departments or urgent care centers

Correct answer: D

Rationale: Individuals living in poverty often face barriers to accessing regular healthcare services, leading them to utilize Emergency Departments or urgent care centers as their primary source of healthcare. These facilities provide immediate care without the need for appointments or insurance, making them more accessible to those in poverty. While primary care physicians and neighborhood clinics are essential for preventive care, individuals in poverty may have difficulty accessing these services due to financial constraints or lack of insurance. Specialists typically require referrals and may not be easily accessible to individuals without stable healthcare coverage. Therefore, Emergency Departments or urgent care centers are the most likely healthcare option for people living in poverty.

3. A nurse is conducting a psychosocial assessment of a young adult. Which observations would lead the nurse to determine that the client is demonstrating a sign of emotional health?

• A. The young adult is sensitive to criticism.
• B. The young adult verbalizes unrealistic fears.
• C. The young adult verbalizes disappointment with life.
• D. The young adult verbalizes satisfaction with friendships.

Correct answer: D

Rationale: The correct answer is that the young adult verbalizes satisfaction with friendships. Emotional health in young adults is characterized by various positive signs, including satisfaction with social interactions and friendships. Expressing contentment with friendships indicates a healthy emotional state, fostering positive social connections. On the other hand, sensitivity to criticism, verbalizing unrealistic fears, and expressing disappointment with life are all indicative of emotional distress and potential mental health challenges. These behaviors can hinder social relationships and overall emotional well-being.

4. The greatest time savers when planning client care include all of the following except:

• A. reacting to the crisis of the moment
• B. setting goals
• C. planning
• D. specifying priorities

Correct answer: A

Rationale: The greatest time-savers when planning client care are activities that facilitate focus and completion of priority items. Time-savers include setting goals, specifying priorities, planning tasks, delegating where appropriate, reassessment, and ongoing evaluation of needs. Reacting to the crisis of the moment is not a time-saving strategy in client care planning; it can lead to inefficiency, lack of focus, and potentially missing important priority items. Therefore, the correct answer is 'reacting to the crisis of the moment.' Choices B, C, and D are essential components for effective client care planning as they help in organizing and prioritizing tasks, setting objectives, and ensuring a structured approach to care delivery.

5. Why is Kleinman's Explanatory Model of Health and Illness significant?

• A. it focuses on the health beliefs of a particular family.
• B. it highlights the impact of culture on health explanations.
• C. it discusses the significant role of popular and folk domains of influence.
• D. it is based on an educational approach.

Correct answer: C

Rationale: Kleinman's Explanatory Model of Health and Illness is significant because it emphasizes the influence of popular and folk domains on health perceptions. Kleinman distinguishes between disease, representing the biomedical view, and illness, reflecting individual understanding. The model underscores that cultural factors shape the significance of popular and folk influences on health beliefs. Choice A is incorrect as the model focuses on broader cultural influences, not individual family beliefs. Choice B is incorrect as it oversimplifies the model's emphasis on various cultural aspects. Choice D is incorrect as the model's significance lies in its cultural framework rather than an educational base.

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