Nursing Elites

1. How should a healthcare provider respond to a patient refusing treatment for religious reasons?

• A. Respect the patient's beliefs
• B. Attempt to persuade the patient
• C. Provide education on treatment benefits
• D. Document the refusal and notify the provider

Correct answer: A

Rationale: Respecting the patient's beliefs is crucial in providing patient-centered care. Attempting to persuade the patient may violate their autonomy and decision-making capacity, leading to a breakdown in trust. Providing education on treatment benefits may be appropriate in other situations but is not the best approach when a patient refuses treatment based on religious reasons. Documenting the refusal and notifying the provider are important steps to ensure proper continuity of care, but the primary response should be to respect the patient's beliefs to maintain a trusting relationship and uphold ethical standards.

2. A nurse is teaching a newly licensed nurse about ergonomic principles. Which of the following actions by the nurse indicates an understanding of the teaching?

• A. Stands with feet shoulder-width apart when lifting a client up in bed.
• B. Raises the client's knees before pulling the client up in bed.
• C. Uses a mechanical lift to move a client from bed to chair.
• D. Places a gait belt around the client's waist before assisting the client to stand.

Correct answer: C

Rationale: Using a mechanical lift is an appropriate ergonomic technique as it reduces the risk of injury to both the nurse and the client by promoting safe client handling practices. Choice A is incorrect as standing with feet shoulder-width apart provides better balance and stability during lifting. Choice B is incorrect as raising the client's knees is not directly related to ergonomic principles. Choice D is incorrect as placing a gait belt around the client's waist is a safety measure but does not specifically demonstrate an understanding of ergonomic principles.

3. A nurse is preparing to administer vancomycin IV to a client. Which of the following actions should the nurse take?

• A. Administer the medication over 30 minutes.
• B. Monitor the client for a decrease in blood pressure during administration.
• C. Assess the IV site for infiltration during administration.
• D. Premedicate the client with an antiemetic prior to administration.

Correct answer: C

Rationale: The correct action the nurse should take when administering vancomycin IV is to assess the IV site for infiltration during administration. Vancomycin is known to cause tissue damage if it infiltrates, making close monitoring crucial. Administering the medication over 30 minutes (Choice A) is a common practice but not the priority in preventing infiltration. Monitoring for a decrease in blood pressure (Choice B) is not directly related to vancomycin administration. Premedicating with an antiemetic (Choice D) is not typically required for vancomycin administration.

4. A nurse working in a rehabilitation facility is developing a discharge plan for a client who has left-sided hemiplegia. Which of the following actions is the nurse's priority?

• A. Consult with a case manager regarding insurance coverage.
• B. Counsel caregivers on respite care options.
• C. Ensure that the client has a referral for physical therapy.
• D. Refer the client to a local stroke support group.

Correct answer: C

Rationale: The correct answer is C: 'Ensure that the client has a referral for physical therapy.' For a client with left-sided hemiplegia, physical therapy is crucial in restoring function and mobility. It is the nurse's priority to ensure the client receives the necessary rehabilitation services. Consulting with a case manager about insurance coverage (Choice A) is important but not the priority at this stage. Counseling caregivers on respite care options (Choice B) and referring the client to a local stroke support group (Choice D) are also valuable but not as essential as ensuring the client has access to physical therapy for rehabilitation.

5. A nurse is caring for a client who is in labor and has an external fetal monitor in place. The nurse observes late decelerations in the fetal heart rate. Which of the following findings should the nurse identify as the cause of late decelerations?

• A. Fetal head compression
• B. Uteroplacental insufficiency
• C. Umbilical cord compression
• D. Fetal hypoxia

Correct answer: B

Rationale: Late decelerations in the fetal heart rate are caused by uteroplacental insufficiency, which results from inadequate blood flow to the placenta. This leads to reduced oxygen and nutrients reaching the fetus during contractions. Choice A, fetal head compression, does not typically cause late decelerations but can result in variable decelerations. Choice C, umbilical cord compression, usually leads to variable decelerations. Choice D, fetal hypoxia, is a broad term and not the direct cause of late decelerations, which are specifically linked to uteroplacental insufficiency.

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