Nursing Elites

1. The LPN needs to delegate a task to the nurse aide who is new to the unit. Which of these is the best option for the nurse to choose in proceeding?

• A. Delegate the task to the nurse aide, confirm understanding, and follow up to ensure the task was safely and correctly done.
• B. Delegate the task to the nurse aide, watch them perform the task without them seeing you, and follow up to ensure the task was done safely and accurately.
• C. Delegate the task to the nurse aide, supervise if needed, and check in after the task to see if help is needed.
• D. Delegate the task to the nurse aide, ensure understanding of the task, and supervise the task being performed.

Correct answer: Delegate the task to the nurse aide, watch them perform the task without them seeing you, and follow up to ensure the task was done safely and accurately.

Rationale: Delegation is transferring responsibility for a task but sharing its accountability. It is the delegator’s responsibility to ensure that the delegatee understands the task before it is performed and to follow up afterward to ensure it was completed correctly and safely. Option B is the best choice because it allows the nurse to observe the nurse aide performing the task without pressure, which can provide insights into the aide's abilities and understanding. This method also allows for immediate feedback and correction if needed. Choice A is incorrect because confirming understanding alone may not provide a complete picture of the aide's competence in performing the task. Choice C is incorrect as it suggests supervising only if needed, which may not provide adequate oversight for a new nurse aide. Choice D is incorrect because supervising the task being performed does not allow for an objective assessment of the aide's abilities and understanding.

2. The client has asked if you would be able to offer any alternative or complementary therapy during their hospitalization. Which of the following would be appropriate to suggest?

• A. Physical therapy
• B. Music therapy
• C. Psychiatric therapy
• D. Occupational therapy

Correct answer: B

Rationale: Music therapy is an appropriate suggestion as an alternative or complementary therapy during hospitalization. Music therapy can help improve the client's condition and comfort level by providing emotional support and reducing stress. Physical therapy and occupational therapy are crucial for rehabilitation and improving physical function, while psychiatric therapy focuses on mental health treatment. These therapies are essential components of care but are not typically considered alternative or complementary therapies in this context.

3. Which of the following statements indicates that the provider understands how to promote rest and sleep for the client?

• A. If you would prefer not to be disturbed, we can postpone all vital signs and assessments until tomorrow morning.
• B. With your physical therapy appointments, you cannot nap more during the day even if your sleep is often interrupted at nighttime.
• C. I can try to incorporate any sleep rituals or an ideal bedtime into your routine.
• D. We cannot group together medications, assessments, and other interventions so you may have multiple interruptions at night.

Correct answer: I can try to incorporate any sleep rituals or an ideal bedtime into your routine.

Rationale: The correct answer is, 'I can try to incorporate any sleep rituals or an ideal bedtime into your routine.' To promote rest and sleep, the provider should consider incorporating the client's preferred sleep rituals or bedtime routine. This statement shows an understanding of the importance of individualizing care to promote restful sleep. Choices A, B, and D do not directly address promoting rest and sleep. Choice A focuses on postponing assessments, Choice B addresses napping during the day, and Choice D mentions multiple interruptions at night, none of which directly support promoting rest and sleep for the client.

4. A client is having a seizure; his blood oxygen saturation drops from 92% to 82%. What should the nurse do first?

• A. Open the airway.
• B. Administer oxygen.
• C. Suction the client.
• D. Check for breathing.

Correct answer: Open the airway.

Rationale: When a client is having a seizure and their blood oxygen saturation drops significantly, the priority action for the nurse is to open the airway. This allows for adequate oxygenation and ventilation. Administering oxygen can come after ensuring the airway is clear. Suctioning the client should be done if there is an airway obstruction, and checking for breathing is part of the assessment but opening the airway takes precedence to ensure proper oxygenation and ventilation during a critical event like a seizure.

5. A client with leukemia is being considered for a bone marrow transplant. The healthcare team is discussing the risks and benefits of this treatment and other possible treatments with the goal of inflicting the least possible harm on the client. Which principle of healthcare ethics is the team practicing?

• A. Fidelity
• B. Nonmaleficence
• C. Autonomy
• D. Justice

Correct answer: Nonmaleficence

Rationale: The correct answer is B: Nonmaleficence. Nonmaleficence is the principle of avoiding harm. In healthcare ethics, practitioners aim not only to do good but also to ensure they do no harm. In this scenario, the healthcare team is discussing treatment options with the intention of inflicting the least harm on the client. Choice A, Fidelity, refers to keeping promises made to clients, families, and healthcare professionals. Choice C, Autonomy, pertains to respecting a person's independence and right to make decisions. Choice D, Justice, involves fairness, equity, and the fair allocation of resources, such as healthcare services.

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