Nursing Elites

1. The discharge planning team is discussing plans for the dismissal of a 16-year-old admitted for complications associated with asthma. The client's mother has not participated in any of the discharge planning processes but has stated that she wants to be involved. Which of the following reasons might prohibit this mother from participating in discharge planning?

• A. The client is an emancipated minor
• B. The mother has to work and is unavailable
• C. The client has a job and a driver's license
• D. The mother does not speak English

Correct answer: A

Rationale: In this scenario, the correct answer is that the client is an emancipated minor. Emancipated minors, even if they are under the age of 18, have the legal right to make decisions about their own healthcare and planning, which may include not wanting their parent involved in the discharge planning process. This status grants them independence from parental involvement in certain situations. The other choices are incorrect because the mother's work schedule, the client's job and possession of a driver's license, and the mother's language proficiency do not inherently prevent her from participating in the discharge planning process, unlike the legal status of being an emancipated minor.

2. Jaime has a diagnosis of schizophrenia with negative symptoms. In planning care for the client, Nurse Brienne would anticipate a problem with:

• A. Auditory hallucinations
• B. Bizarre behaviors
• C. Ideas of reference
• D. Motivation for activities

Correct answer: D

Rationale: In clients with negative symptoms of schizophrenia, such as Jaime, a common problem is avolition, which is the lack of motivation for activities. These 'negative' symptoms are characterized by inexpressive faces, blank looks, monotone speech, few gestures, and a seeming lack of interest in the world. Patients may also experience an inability to feel pleasure or act spontaneously. It is crucial to differentiate between the lack of expression and lack of feeling, as well as between lack of will and lack of activity. Auditory hallucinations (choice A) are positive symptoms, not typically associated with negative symptoms of schizophrenia. Bizarre behaviors (choice B) are more aligned with positive symptoms like disorganized behavior. Ideas of reference (choice C) involve incorrectly interpreting casual incidents and external events as having direct reference to oneself, which is not directly related to motivation for activities seen in negative symptoms.

3. During a health history assessment of a new patient, which data should be the focus for patient teaching?

• A. Age and gender
• B. Saturated fat intake
• C. Hispanic/Latino ethnicity
• D. Family history of diabetes

Correct answer: B

Rationale: The correct answer is saturated fat intake. Behaviors play a crucial role in health outcomes, and saturated fat intake is a modifiable behavior that can significantly impact a patient's health. By focusing on educating the patient about reducing saturated fat intake, the healthcare provider can empower the patient to make positive changes. While age, gender, ethnicity, and family history are important factors in understanding a patient's health status, they are not behaviors that can be directly modified through patient teaching. Therefore, these factors are essential for developing an individualized care plan but are not the primary focus of patient teaching. Saturated fat intake directly relates to dietary habits, which can be altered through education and support to promote better health outcomes.

4. What ethical principle has led to the need for informed consent?

• A. Autonomy
• B. Justice
• C. Fidelity
• D. Beneficence

Correct answer: A

Rationale: Autonomy is the ethical principle that emphasizes an individual's right to make their own decisions if they are mentally competent. Informed consent is a direct result of this principle, as it ensures that patients are fully informed before agreeing to any medical intervention. Autonomy is crucial in healthcare as it respects patients' rights and promotes self-determination. Justice, fidelity, and beneficence are important ethical principles in healthcare, but they do not directly lead to the need for informed consent. Justice focuses on fairness and equal treatment, fidelity on trustworthiness and loyalty, and beneficence on doing good for the patient's benefit.

5. One of the complications of complete bed rest and immobility is which of the following?

• A. Plantar flexion
• B. Dorsiflexion
• C. Extension contractures
• D. Adduction contractures

Correct answer: A

Rationale: Plantar flexion, or foot drop, is a common complication of complete bed rest and immobility. This condition occurs due to the weakening of muscles that lift the foot, leading to the foot dragging or being unable to clear the ground during walking. Dorsiflexion refers to moving the foot upwards, which is not a typical complication of immobility. Extension contractures involve the inability to fully extend a joint, while adduction contractures refer to the inability to move a limb away from the body. These types of contractures can also occur with immobility, but they are not specifically associated with foot drop.

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