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1. The staff nurse delegates AM care for two patients to the UAP (Unlicensed Assistive Person). What principle of delegation is the nurse following?
- A. Delegation requires a situation with clearly defined superiors.
- B. Delegation can only exist with a subordinate.
- C. Delegation is a tool used by various healthcare professionals.
- D. You can delegate only those tasks.
Correct answer: D
Rationale: The correct answer is D: 'You can delegate only those tasks.' Delegation in nursing involves transferring responsibility for the performance of a task while retaining accountability for the outcome. The principle of delegation does not require a situation with clearly defined superiors (choice A). Delegation can exist not only with a subordinate but also with colleagues or other healthcare team members (choice B). Delegation is not exclusive to nurses and is a tool used by various healthcare professionals (choice C). Therefore, the best choice is D as it accurately reflects the principle of delegation in nursing.
2. Which clinical manifestations should the nurse anticipate when assessing a child for hypoglycemia?
- A. Lethargy
- B. Thirst
- C. Nausea and vomiting
- D. Shaky feeling and dizziness
Correct answer: D
Rationale: The correct answer is D: 'Shaky feeling and dizziness.' Hypoglycemia in children often presents with symptoms like shakiness, dizziness, sweating, hunger, and irritability. These symptoms occur because the brain and body are deprived of the glucose they need to function properly. Choices A, B, and C are incorrect because lethargy, thirst, nausea, and vomiting are not typically primary manifestations of hypoglycemia in children.
3. A nurse on a postsurgical unit is providing care for a 76-year-old female client who is two days post-hemiarthroplasty (hip replacement) and who states that her pain has been out of control for the last several hours, though she is not exhibiting signs of pain. Which guideline should the nurse use for short-term and long-term treatment of the client's pain?
- A. Pain is what the client says it is, even if she is not exhibiting outward signs.
- B. Pain should be treated only when it is associated with observable symptoms.
- C. Long-term opioid use is generally safe for elderly clients in a hospital setting.
- D. The client's pain should be reassessed after every dose of pain medication.
Correct answer: A
Rationale: Pain is a subjective experience, and the client's report of pain should be taken seriously even if there are no outward signs. Choice B is incorrect because pain can be present without observable symptoms, and waiting for observable signs may delay appropriate pain management. Choice C is incorrect because the safety of long-term opioid use in elderly clients is a complex issue and should be carefully evaluated due to the risk of adverse effects. Choice D is incorrect because while pain reassessment is important, it should not be limited to just after medication administration but should occur regularly to ensure adequate pain control.
4. According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse?
- A. A client rudely complaining about limited visiting hours
- B. A client exhibiting aggressive behavior toward another client
- C. A client stating that no one cares
- D. A client verbalizing feelings of failure
Correct answer: B
Rationale: The correct answer is B. According to Maslow's hierarchy of needs, safety needs are considered fundamental and must be addressed before higher-level needs. When a client exhibits aggressive behavior toward another client, it poses an immediate threat to safety and requires priority intervention by the nurse to ensure the well-being of all individuals involved. Clients who are rude in their complaints (Choice A), express feelings of failure (Choice D), or state that no one cares (Choice C) are addressing higher-level needs related to social interactions, esteem, and self-actualization, respectively, which can be addressed once safety needs are secured.
5. A hospital patient's complex medical history includes a recent diagnosis of kidney cancer. Which of the following medications is used to treat metastatic kidney cancer?
- A. Filgrastim (Neupogen)
- B. Aldesleukin (Proleukin)
- C. Interferon alfa-2b (Intron A)
- D. Darbepoetin alfa (Aranesp)
Correct answer: B
Rationale: The correct answer is B: Aldesleukin (Proleukin). Aldesleukin is a medication used in the treatment of metastatic kidney cancer. It is a recombinant interleukin-2 that works by stimulating the immune system to attack cancer cells. Choice A, Filgrastim, is a medication used to stimulate the production of white blood cells. Choice C, Interferon alfa-2b, is used in the treatment of certain cancers but not specifically metastatic kidney cancer. Choice D, Darbepoetin alfa, is used to treat anemia by stimulating red blood cell production and is not indicated for metastatic kidney cancer.
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