Nursing Elites

1. Central venous access devices (CVADs) are frequently utilized to administer chemotherapy. What is an advantage of using CVADs for chemotherapeutic agent administration?

• A. CVADs are more expensive than a peripheral IV.
• B. Weekly administration is possible.
• C. Chemotherapeutic agents can be caustic to smaller veins.
• D. The client or family can administer the drug at home.

Correct answer: C

Rationale: The correct advantage of using CVADs for chemotherapeutic agent administration is that chemotherapeutic agents can be caustic to smaller veins. Many chemotherapeutic drugs are vesicants, which can cause tissue damage even in low concentrations. Using a CVAD to administer these agents into a large vein is optimal as it reduces the risk of damage. Choice A is incorrect as CVADs are actually more expensive than a peripheral IV, making it a disadvantage. Choice B is incorrect because the frequency of administration depends on the specific drug being administered, not on the access device, so it does not represent a universal advantage. Choice D is incorrect because IV chemotherapeutic agents are typically not self-administered at home; they are usually given in a hospital, outpatient, or clinic setting, making it an invalid advantage of using CVADs.

2. The LPN on shift notices a client coming into the clinic with bruises on his arm. The client seems very afraid and doesn't speak much, which concerns the nurse because these are signs of physical abuse. The nurse should ____.

• A. use therapeutic communication to talk to the client and offer support while reporting the findings to the appropriate authorities based on the state requirements and protocols
• B. report the findings to the appropriate authorities based on the state requirements and protocols
• C. ignore the bruises, as this is not why the client is being treated and is not appropriate for the nurse to address
• D. report the suspected abuse to another nurse and collaborate on how to handle it

Correct answer: B

Rationale: In cases of suspected abuse, healthcare providers have a legal and ethical obligation to report such incidents to the relevant authorities. This not only ensures the safety and well-being of the client but also helps in preventing further harm. Option A is incorrect as attempting to gather evidence of abuse may interfere with the official investigation and is not the nurse's role. Offering support is crucial, but the priority is to report the findings to the appropriate authorities. Option C is incorrect as ignoring signs of abuse goes against the duty of a healthcare provider to protect their clients. Option D is incorrect as reporting suspected abuse to other nurses without involving the appropriate authorities may delay necessary actions and intervention.

3. After breast reconstruction secondary to breast cancer, the nurse should recognize which of the following expected client outcomes as evidence of a favorable response to nursing interventions related to disturbed body image?

• A. maintaining adequate tissue perfusion
• B. demonstrating behaviors that reduce fears
• C. restored body integrity
• D. remaining free of infection

Correct answer: C

Rationale: The correct answer is 'restored body integrity.' This outcome is crucial in addressing disturbed body image following breast reconstruction. Restored body integrity reflects a positive perception of one's body after surgery, contributing to improved body image. Choices A, 'maintaining adequate tissue perfusion,' are more related to physiological outcomes and are not directly linked to body image concerns. Choice B, 'demonstrating behaviors that reduce fears,' is associated with anxiety management, not body image. Choice D, 'remaining free of infection,' pertains to preventing infections and does not directly address body image concerns.

4. Which of the following actions should the LPN perform for a client with an active digoxin IV order? Select all that apply.

• A. plug the patient to the ECG Monitor
• B. Administer the medication over at least 5 minutes.
• C. Monitor respirations during administration.
• D. Monitor the client's pulse for 1 minute prior to administration.

Correct answer: D

Rationale: The correct actions for the LPN to perform for a client with an active digoxin IV order are to monitor ECG rhythm throughout administration and monitor the client's pulse for 1 minute prior to administration. These actions are crucial as digoxin affects the heart's electrical activity, and it should not be administered if the client's pulse is less than 60 bpm. Monitoring respirations and blood pressure are not directly associated with digoxin administration. Administering IV medications is typically outside the LPN's scope of practice.

5. During an interview, what action should a nurse conducting an interview with a client take to collect subjective data?

• A. Takes minimal notes to avoid impeding observation of the client's nonverbal behaviors
• B. Takes a great deal of notes to allow the client to continue at his or her own pace as the nurse records what he or she is saying
• C. Takes notes because this allows the nurse to break eye contact with the client, which may increase the client's level of comfort
• D. Takes notes to allow the nurse to shift attention away from the client, which may make the nurse more comfortable

Correct answer: A

Rationale: During an interview, a nurse should minimize note-taking to focus on the client and not impede the conversation. Taking minimal notes allows the nurse to effectively observe the client's nonverbal behaviors, which provide valuable subjective data. Option B, taking many notes, is incorrect as it can distract the nurse from the client's cues and hinder interaction. Option C, taking notes to break eye contact, is incorrect as it may decrease the client's comfort level and disrupt communication. Option D, taking notes to shift attention away from the client, is incorrect as it diminishes the client's importance and may make them uncomfortable during sensitive discussions. Therefore, the correct approach is for the nurse to take minimal notes, ensuring effective observation of the client's nonverbal behaviors while collecting subjective data.

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