Nursing Elites

1. Which task should not be performed by the licensed practical nurse?

• A. Inserting a Foley catheter
• B. Discontinuing a nasogastric tube
• C. Obtaining a sputum specimen
• D. Initiating a blood transfusion

Correct answer: D

Rationale: A licensed practical nurse should not initiate a blood transfusion. LPNs can assist with transfusions and verify ID numbers but should not be assigned to initiate the procedure. Inserting Foley catheters, discontinuing nasogastric tubes, and obtaining sputum specimens are within the scope of practice for LPNs. Therefore, options A, B, and C are tasks that LPNs can perform, making them incorrect choices.

2. Several clients are admitted to the emergency room following a three-car vehicle accident. Which clients can be assigned to share a room in the emergency department during the disaster?

• A. The schizophrenic client experiencing visual and auditory hallucinations and the client with ulcerative colitis
• B. The client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm
• C. A child with fixed and dilated pupils and his parents, and the client with a frontal head injury
• D. The client who arrives with a large puncture wound to the abdomen and the client with chest pain

Correct answer: B

Rationale: The correct answer is to assign the client who is 6 months pregnant with abdominal pain and the client with facial lacerations and a broken arm to share a room. The pregnant client needs close monitoring due to the abdominal pain, and the client with facial lacerations and a broken arm requires immediate attention for wound care and possible fracture management. Choice A should not be assigned together as the schizophrenic client experiencing visual and auditory hallucinations needs a separate room for privacy and safety, and the client with ulcerative colitis may require isolation due to the risk of infection. Choice C is incorrect because the child with fixed and dilated pupils is likely in a critical condition and should be in a private room with parents, while the client with a frontal head injury needs a separate room for focused care. Choice D is also incorrect as the client with a large puncture wound to the abdomen needs immediate attention in a separate room, and the client with chest pain requires evaluation and monitoring in a separate setting as well.

3. A 12-year-old male is brought to his primary care provider to determine whether sexual abuse has occurred. The mother states, 'Because there is no permanent physical damage, he does not need any more treatment.' The nurse's response should be based on which of the following pieces of information?

• A. Male victims of sexual abuse can have long-term psychological problems.
• B. Survivors of male sexual abuse might become confused about their sexual identity.
• C. Unless treated, all male sex abuse survivors grow up to abuse other children.
• D. All children who have been sexually abused have the same needs, regardless of gender.

Correct answer: B

Rationale: Male children are sexually abused nearly as often as female children. Perpetrators are usually men but can be women. Needs of male children who have been sexually abused might be different from the needs of female survivors. Male survivors might respond in anger, question their sexuality, use alcohol and other drugs, and might try to prove their masculinity by performing daring acts. It is crucial for the nurse to consider these potential outcomes, making choice B the correct answer. Choice A is incorrect because male victims of sexual abuse can indeed have long-term psychological problems, so the nurse should be aware of this issue. Choice C is incorrect as not all male sex abuse survivors grow up to abuse other children, which is a misconception. Choice D is incorrect because the needs of children who have been sexually abused can vary based on various factors, including gender, so it is important to consider individual differences.

4. During the work phase of the nurse-client relationship, the client says to her primary nurse, "You think that I could walk if I wanted to, don't you?"? What is the best response by the nurse?

• A. "Yes, if you really wanted to, you could."?
• B. "Tell me why you're concerned about what I think."?
• C. "Do you think you could walk if you wanted to?"?
• D. "I think you're unable to walk now, whatever the cause."?

Correct answer: D

Rationale: This response answers the question honestly and nonjudgmentally and helps to preserve the client's self-esteem. The nurse acknowledges the client's current inability to walk without attributing it to the client's desire. Choice A provides a positive but unrealistic statement that may diminish the client's self-esteem by implying a lack of effort. Choice B deflects the client's question and does not address the underlying concern. Choice C may increase the client's anxiety by suggesting unresolved psychological conflicts related to walking.

5. The ethical principle of keeping professional promises or obligations is:

• A. veracity
• B. autonomy
• C. fidelity
• D. beneficence

Correct answer: C

Rationale: The correct answer is fidelity. Fidelity is the ethical principle that refers to keeping professional promises or obligations. Veracity, however, relates to truth-telling. Autonomy is about client self-determination and decision-making. Beneficence, on the other hand, involves doing good and is crucial in the provision of nursing care.

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