Nursing Elites

1. Ms. Petty is having difficulty falling asleep. Which of the following measures promote sleep?

• A. exercising vigorously for 20 minutes each night starting at 9:30 p.m.
• B. taking a cool shower and drinking a hot cup of tea
• C. watching TV nightly until midnight
• D. getting a back rub and drinking a glass of warm milk

Correct answer: D

Rationale: Getting a back rub and drinking a glass of warm milk are appropriate measures to promote sleep as they can help relax the body and induce sleepiness. Exercising vigorously, as suggested in choice A, can be counterproductive as it stimulates the body rather than relaxing it, making it harder to fall asleep. Choice B, taking a cool shower and drinking a hot cup of tea, may also increase alertness due to the temperature changes and the caffeine in tea, which can interfere with falling asleep. Watching TV until midnight, as in choice C, exposes the individual to blue light and mental stimulation, making it harder to fall asleep. Therefore, choice D is the best option to promote sleep in this scenario.

2. Which action by the nurse represents the ethical principle of benevolence?

• A. The nurse administers an immunization to a child even though it may cause discomfort
• B. The nurse follows a plan of care designed to relieve pain in a client with cancer
• C. The nurse provides equal amounts of care to all assigned clients on the basis of illness acuity
• D. The nurse upholds a client's decision to refuse chemotherapy for lung cancer

Correct answer: A

Rationale: Benevolence is taking action to help others. In this scenario, administering an immunization to a child, even though it may cause discomfort, aligns with the principle of benevolence as the benefits of protection from disease outweigh the temporary discomfort. Fidelity refers to keeping promises made to clients, families, and other healthcare professionals. Autonomy is a person's independence, and respecting autonomy means agreeing to respect an individual's right to determine their course of action. Justice refers to fairness and equity, including the fair allocation of resources, such as nursing care for all clients. Choice B is incorrect as it pertains more to the ethical principle of beneficence rather than benevolence, which focuses on doing good for others without an expectation of something in return. Choices C and D are incorrect as they do not directly align with the principle of benevolence.

3. Ethical and moral issues concerning restraints include all of the following except:

• A. emotional impact on the client and family.
• B. dignity of the client.
• C. client's quality of life.
• D. policies and procedures.

Correct answer: D

Rationale: The correct answer is 'policies and procedures.' While policies and procedures are essential for managing restraints, they are not in themselves ethical or moral issues. The emotional impact on the client and family, the dignity of the client, and the client's quality of life are all ethical and moral concerns related to the use of restraints. These aspects focus on the well-being, respect, and rights of the individual, which are fundamental ethical considerations in healthcare practice. Choices A, B, and C are directly tied to ethical and moral considerations by highlighting the impact on individuals involved and their overall quality of life and dignity, making them key factors to address in ethical decision-making.

4. Which of these clients should the LPN/LVN see first?

• A. a client with a newly placed NG tube who is complaining of pain around the face and a plugged nose
• B. a post-op prostatectomy client who complains of bladder spasms and blood in his foley bag
• C. a client in an arm cast who is 2 days post-op and reports feelings of numbness and tingling in her affected arm
• D. a client newly diagnosed with Hepatitis A who reports stomach pain and itchy skin

Correct answer: C

Rationale: Numbness and tingling hours or days after a cast is applied may indicate compartment syndrome and should be reported to a medical provider right away. This is a potential emergency situation that requires immediate attention to prevent complications. The other options present expected or typical symptoms related to their diagnosis, which do not require immediate intervention. Complaints related to a newly placed NG tube such as pain around the face and a plugged nose may require assessment and intervention but are not as urgent as potential compartment syndrome. Bladder spasms and blood in the foley bag post-prostatectomy are common postoperative issues that can be addressed after the client in the arm cast with potential compartment syndrome is seen. Stomach pain and itchy skin in a client with Hepatitis A are common symptoms of the condition and do not indicate an emergency situation.

5. What does carrying a donor card for organ donation mean?

• A. medical care is altered to obtain organs for donation in the event of serious injuries
• B. the family or legally responsible party of a client has no decision-making authority in the event that the client is considered for organ donation
• C. a client is allowed to revoke their decision for organ donation at any time
• D. a client is considered an organ donor for multiple organs or tissues

Correct answer: C

Rationale: Carrying a donor card for organ donation signifies that an individual can decide to revoke their decision for organ donation at any point. This choice empowers the individual to change their mind regarding organ donation. The family or legally responsible party of a client still holds decision-making authority in the event that the client is considered for organ donation. When organ donation is being considered, all organs or tissues the donor wishes to donate are evaluated for donation suitability; it's not limited to just one organ or tissue. It's important to note that medical care for an individual is not altered to hasten the declaration of death for organ donation purposes; the focus is on providing immediate care and resuscitation to the individual.

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