Nursing Elites

1. The nurse has received funding to design a health promotion project for African American women who are at risk for developing breast cancer. Which resource is most important in designing this program?

• A. Participation of community leaders in planning the program
• B. Latest research on breast cancer risk factors
• C. Partnership with local healthcare providers
• D. Health surveys of African American women in the community

Correct answer: A

Rationale: The most important resource in designing a health promotion project for African American women at risk for breast cancer is the participation of community leaders in planning the program. Involving community leaders helps ensure that the program is culturally relevant, addresses the specific needs of the target population, and fosters trust and engagement. While the latest research on breast cancer risk factors, partnership with local healthcare providers, and health surveys of African American women are valuable resources, they are not as crucial as community involvement for tailoring the program effectively.

2. A client is newly prescribed lithium for bipolar disorder. Which finding is most important to report to the healthcare provider?

• A. A serum lithium level of 1.2 mEq/L.
• B. Fine hand tremors noted after starting the medication.
• C. A blood pressure of 110/60 mmHg.
• D. A serum sodium level of 140 mEq/L.

Correct answer: B

Rationale: The correct answer is B. Fine hand tremors noted after starting lithium are an early sign of lithium toxicity. It is crucial to report this finding to the healthcare provider promptly. Adjusting the dose or monitoring serum levels more closely may be necessary to prevent further toxicity. Choice A, a serum lithium level of 1.2 mEq/L, is within the therapeutic range (0.6-1.2 mEq/L) for treating bipolar disorder. Choice C, a blood pressure of 110/60 mmHg, and Choice D, a serum sodium level of 140 mEq/L, are within normal limits and not directly related to lithium therapy or toxicity.

3. A client with peripheral vascular disease reports leg pain while walking. What intervention is most effective for the nurse to recommend?

• A. Recommend elevating the legs above the heart.
• B. Encourage the client to increase walking distance gradually.
• C. Encourage the client to avoid sitting or standing for long periods.
• D. Instruct the client to use warm compresses for pain relief.

Correct answer: B

Rationale: The correct answer is to encourage the client to increase walking distance gradually. This intervention is effective because gradual increases in walking distance promote circulation, improve oxygen delivery to tissues, and help reduce leg pain caused by peripheral vascular disease. Elevating the legs above the heart (Choice A) may be beneficial in other conditions like venous insufficiency but not specifically for peripheral vascular disease. Encouraging the client to avoid sitting or standing for long periods (Choice C) can help prevent blood pooling but does not directly address the walking-induced leg pain. Instructing the client to use warm compresses for pain relief (Choice D) may provide temporary relief but does not address the underlying circulation issues associated with peripheral vascular disease.

4. The nurse is caring for a group of clients with the help of a PN. Which nursing actions should the nurse assign to the PN?

• A. All of the above
• B. Administer a dose of insulin per sliding scale for a client with Type 2 DM
• C. Obtain postoperative vital signs for a client one day following unilateral knee arthroplasty
• D. Perform daily surgical dressing change for a client who had an abdominal hysterectomy

Correct answer: A

Rationale: All of these tasks fall within the PN's scope of practice, which includes performing surgical dressing changes, taking postoperative vital signs, and administering insulin under supervision. The RN can delegate these tasks to the PN safely. Choice A is the correct answer because all the tasks mentioned are appropriate for delegation to a PN. Choice B should not be assigned to a PN as only RNs should administer insulin. Choice C is suitable for delegation to a PN as obtaining vital signs falls within their scope of practice. Choice D is also appropriate for delegation to a PN as performing surgical dressing changes is within their scope of practice.

5. A nurse is working with a new graduate nurse on the delegation of tasks to the unlicensed assistive personnel (UAP). Which task would the new nurse need more teaching about delegating?

• A. Taking a client's blood pressure
• B. Providing oral hygiene for a client
• C. Assessing a client's pain level
• D. Assisting a client with ambulation

Correct answer: C

Rationale: The correct answer is C: Assessing a client's pain level. This task involves clinical judgment and interpretation, which are within the scope of a licensed nurse's practice. Delegating pain assessment to unlicensed personnel could lead to errors in pain management and inappropriate interventions. Choices A, B, and D involve tasks that can be safely delegated to unlicensed assistive personnel as they do not involve interpretation or nursing judgment. Taking a client's blood pressure, providing oral hygiene, and assisting with ambulation are all routine tasks that can be appropriately assigned to UAP under the supervision of a licensed nurse.

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