Nursing Elites

1. To accommodate a patient who is an Orthodox Jew, you would assure that her diet does not include which of the following?

• A. Any combination of meat and milk at the same meal
• B. Fish with scales
• C. Salmon
• D. Grape juice

Correct answer: A

Rationale: The correct answer is A. Orthodox Jewish dietary laws prohibit mixing meat and dairy in the same meal, so to accommodate an Orthodox Jew, you should ensure that their diet does not include any combination of meat and milk at the same meal. Choices B, C, and D are not prohibited in a kosher diet. Fish with scales, including salmon, are typically kosher, and grape juice is also permissible under kosher guidelines if certified. Therefore, options B, C, and D are acceptable in an Orthodox Jewish diet, while option A contradicts their dietary laws.

2. Which task could the PN safely delegate to the UAP?

• A. Oral feeding of a two-year-old child after application of a hip spica cast
• B. Assessment of the placement and patency of a NG tube
• C. Participation in staff rounds to record notes regarding client goals
• D. Evaluation of a client's incisional pain following narcotic administration

Correct answer: A

Rationale: The correct answer is A because oral feeding of a child is a task that can be safely delegated to an unlicensed assistive personnel (UAP). This task involves providing basic care and does not require specialized nursing skills. Choices B, C, and D involve assessments, recording client goals, and evaluating pain, respectively, which all require specialized nursing knowledge, judgment, and skills. These tasks are not within the scope of practice for a UAP.

3. A client confides to the nurse that the client has been substituting herbal supplements for high blood pressure instead of the prescribed medication. How should the nurse respond first?

• A. Ask the client's reason for choosing to take herbs instead of prescribed medication
• B. Reinforce that the healthcare provider prescribed the medication for a reason
• C. Have the client use their own words to describe complications of high blood pressure
• D. Point out the risks of not taking the prescribed medication rather than herbal supplements

Correct answer: A

Rationale: The correct answer is to ask the client's reason for choosing to take herbs instead of prescribed medication. Understanding the client's rationale for using herbal supplements allows the nurse to explore any misconceptions and provide education on the importance of the prescribed medication. Choice B is incorrect because simply reinforcing the prescription does not address the client's concerns or reasons for using herbal supplements. Choice C does not directly address the immediate concern of the client substituting medication with herbal supplements. Choice D focuses on the risks of not taking the prescribed medication rather than herbal supplements, which is not the most appropriate initial response.

4. What information should the PN collect during the admission assessment of a terminally ill client to an acute care facility?

• A. Name of the funeral home to contact
• B. Client's wishes regarding organ donation
• C. Contact information for the client's next of kin
• D. Health care proxy information

Correct answer: B

Rationale: Correct Answer: B. Understanding the client's wishes regarding organ donation is crucial as it aligns with end-of-life care preferences and ensures that the client's decisions are respected. While obtaining the name of a funeral home (Choice A) may be necessary, it is not typically part of the initial admission assessment. Contact information for the client's next of kin (Choice C) is important for communication but may not be directly related to the client's immediate end-of-life wishes. Health care proxy information (Choice D) is vital for decision-making if the client becomes incapacitated but may not be the primary focus during the initial admission assessment.

5. A client with a recent total knee replacement is scheduled for physical therapy. The client refuses to participate, stating that the pain is too intense. What should the nurse do first?

• A. Administer the prescribed analgesic and encourage participation after it takes effect.
• B. Reschedule the physical therapy session for later in the day.
• C. Explain the importance of physical therapy for recovery.
• D. Notify the physical therapist of the client's refusal.

Correct answer: A

Rationale: Administering pain medication before physical therapy helps manage the pain, making it easier for the client to participate in the necessary exercises to improve recovery and prevent complications such as joint stiffness. Choice B is not the first step as addressing the pain should take precedence. Choice C is important but should come after managing the pain to facilitate participation. Choice D involves another healthcare provider and is not the immediate action needed in this situation.

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