Nursing Elites

1. What is the intent of the Patient Self Determination Act (PSDA) of 1990?

• A. Enhance personal control over healthcare decisions.
• B. Encourage medical treatment decision making prior to need.
• C. Establish a federal standard for living wills and durable powers of attorney.
• D. Emphasize client education.

Correct answer: B

Rationale: The correct answer is B: The purpose of the PSDA is to encourage medical treatment decision-making before it becomes necessary. This legislation aims to empower individuals to make their own healthcare choices in advance. Choice A is incorrect because while enhancing personal control over healthcare decisions is important, the primary goal of the PSDA is to facilitate medical decision-making before the need arises. Choice C is incorrect as the PSDA does not establish a federal standard for living wills and durable powers of attorney; instead, it encourages individuals to create their own advance directives according to state-specific regulations. Choice D is incorrect because while client education is valuable, the main focus of the PSDA is on empowering individuals to plan for their future healthcare needs.

2. Which of the following is most likely to impact the body image of an infant newly diagnosed with Hemophilia?

• A. immobility
• B. altered growth and development
• C. hemarthrosis
• D. altered family processes

Correct answer: D

Rationale: Altered Family Processes is a significant factor that can impact the body image of an infant newly diagnosed with Hemophilia. Infants are highly sensitive to the reactions of their caregivers, and a new diagnosis like Hemophilia can introduce stress and uncertainties into the family dynamics. This can affect the infant's sense of security, trust development, and how they perceive themselves. Immobility, while a potential long-term effect of Hemophilia, is not the immediate impact on body image for a newly diagnosed infant. Altered growth and development would take time to manifest and would not be an immediate concern after a recent diagnosis. Hemarthrosis, although a characteristic symptom of Hemophilia, is a physical manifestation rather than a direct influence on body image perception in a newly diagnosed infant.

3. Nurses caring for clients who have cancer and are taking opioids need to assess for all of the following except:

• A. tolerance.
• B. constipation.
• C. sedation.
• D. addiction.

Correct answer: D

Rationale: The correct answer is 'addiction.' When caring for clients with cancer who are taking opioids, nurses need to assess for tolerance, constipation, and sedation as these are common side effects of opioid use. Addiction is not a primary concern when managing pain in terminally ill clients, as the goal is effective pain management rather than addiction prevention. Tolerance refers to the body's adaptation to the opioid over time, requiring higher doses for the same effect. Constipation and sedation are common side effects of opioids that nurses need to monitor and manage. Addiction is not a major concern in this population as the focus is on providing comfort and pain relief.

4. A nurse helps a young adult conduct a personal lifestyle assessment. The nurse carefully reviews the assessment with the young adult for which reason?

• A. Young adults may ignore physical symptoms and postpone seeking health care
• B. Young adults are unable to afford health insurance
• C. Young adults are at risk for a serious illness
• D. Young adults are exposed to hazardous substances

Correct answer: A

Rationale: The corrected answer is A: Young adults may ignore physical symptoms and postpone seeking health care. Young adults are usually quite active, experience severe illnesses less commonly than members of older age groups, tend to ignore physical symptoms, and often postpone seeking health care. Clients in this developmental stage may benefit from a personal lifestyle assessment to identify habits that increase the risk for various chronic diseases. Choice B is incorrect because the ability to afford health insurance is not the primary reason for conducting a personal lifestyle assessment. Choice C is incorrect because young adults are not inherently at higher risk for serious illness compared to other age groups. Choice D is incorrect because exposure to hazardous substances is not the main focus when conducting a personal lifestyle assessment.

5. A nurse is preparing to auscultate a fetal heart rate (FHR). The nurse performs the Leopold maneuvers to determine the position of the fetus and then places the fetoscope over which part of the fetus?

• A. Back of the fetus
• B. Carotid artery in the neck of the fetus
• C. Brachial area of one extremity of the fetus
• D. Chest of the fetus

Correct answer: A

Rationale: The nurse would use the Leopold maneuvers to identify the position of the fetus and determine the location of the fetal back. The fetal heart rate (FHR) is most easily heard through the fetal back because it usually lies closest to the surface of the maternal abdomen. Auscultation of the FHR over the chest, carotid artery, or brachial area is not possible due to the fetal position within the maternal abdomen. Placing the fetoscope over the carotid artery or brachial area would not yield the fetal heart rate, and the chest area is not typically used for auscultating the FHR.

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