Nursing Elites

1. The nurse is caring for a client awaiting test results on a biopsy. The client is unconscious, and the physician informs the client's spouse that the biopsy came back positive for cancer. The spouse asks the nurse if they will not share this news with the client because they would prefer the client be unaware of the diagnosis. Which of the following responses is most appropriate?

• A. "I will have a psychiatrist confirm whether the news will cause negative effects, and if so, I will comply with your request."?
• B. "For ethical reasons, I am unable to withhold this information from the client."?
• C. "You do not have the option to sign paperwork stating you are accepting the risk of not sharing this with the client."?
• D. "You must have a durable power of attorney for healthcare advanced directive in place before I can consider this request."?

Correct answer: B

Rationale: The correct response is, "For ethical reasons, I am unable to withhold this information from the client."? The ethical principle of veracity requires that the nurse is truthful with the client and does not withhold information even if it is requested by the family. Choice A is incorrect because seeking a psychiatrist's confirmation is not necessary to uphold the ethical principle of truth-telling. Choice C is incorrect as implying that signing paperwork overrides the nurse's ethical obligation to be honest with the client is inappropriate. Choice D is also incorrect as a durable power of attorney is not relevant in this situation where the spouse is asking the nurse to withhold information.

2. A health care provider asks the nurse caring for a client with a new colostomy to request the hospital's stoma nurse to visit the client and assist with colostomy care. The nurse initiates the consultation, understanding that the stoma nurse will be able to influence the client because of which type of power?

• A. Expert power
• B. Referent power
• C. Coercive power
• D. Reward power

Correct answer: A

Rationale: Power is the ability to influence others to achieve goals. Expert power results from knowledge and skills that one possesses that are needed by others. In this scenario, the stoma nurse's expertise in colostomy care gives them the ability to influence the client effectively. Reward power is based on the ability to grant rewards and favors, which is not applicable in this situation. Coercive power is based on fear and the ability to punish, which is not the case in seeking assistance for colostomy care. Referent power results from followers' desire to identify with a powerful person, which is not the primary influence in this context.

3. Which cultural group has the highest incidence of inflammatory bowel disease (IBD)?

• A. Asians
• B. Caucasians
• C. Hispanics
• D. African Americans

Correct answer: B

Rationale: The correct answer is Caucasians. Studies have shown that Caucasians have the highest incidence of inflammatory bowel disease (IBD) compared to other cultural groups. While IBD can affect individuals from various backgrounds, the prevalence is notably higher in Caucasians. Asians, Hispanics, and African Americans have a lower incidence of IBD compared to Caucasians, making them incorrect choices in this context.

4. Which is the correct order regarding the hierarchy of members of the nursing team from least authority to highest authority?

• A. LPN, staff nurse, charge nurse, nurse manager
• B. Staff nurse, LPN, nurse manager, charge nurse
• C. LPN, staff nurse, charge nurse, nurse manager
• D. LPN, staff nurse, charge nurse, nurse manager

Correct answer: C

Rationale: The correct hierarchy order from least to highest authority in the nursing team is LPN (Licensed Practical Nurse), staff nurse, charge nurse, and nurse manager. LPNs have the least authority, followed by staff nurses who are supervised by charge nurses. Nurse managers oversee the charge nurses, making them the highest authority in this hierarchy. Therefore, choices A, B, and D are incorrect as they do not follow the correct order of authority within the nursing team.

5. What is the appropriate intervention for a client who is restrained?

• A. Remove the restraints and provide skin care every hour.
• B. Document the condition of the client's skin every 3 hours.
• C. Assess the restraint every 30 minutes
• D. Tie the restraint to the side rails.

Correct answer: C

Rationale: The correct intervention when a client is restrained is to assess the restraint every 30 minutes. This ensures the safety and well-being of the client by checking for proper fit, circulation, and signs of distress. Removing restraints and providing skin care every hour may not be necessary and could increase the risk of skin breakdown. Documenting the skin condition every 3 hours is important but not the immediate intervention needed when a client is restrained. Tying the restraint to the side rails is unsafe and can cause harm to the client, as restraints should be secured to the bed frame or an immovable part of the bed.

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