Nursing Elites

1. Who may legally give informed consent?

• A. an 86-year-old male with advanced Alzheimer's disease
• B. a 14-year-old girl needing an appendectomy who is not an emancipated minor
• C. a 14-year-old girl needing an appendectomy who is not an emancipated minor
• D. a 6-month-old baby needing bowel surgery

Correct answer: C

Rationale: The correct answer is a 14-year-old girl needing an appendectomy who is not an emancipated minor. Informed consent can be given by individuals who are competent and not minors. Minors are generally unable to provide informed consent unless they are emancipated. Choice A is incorrect because an 86-year-old male with advanced Alzheimer's disease is considered incompetent to make decisions. Choice D is incorrect because a 6-month-old baby is unable to provide consent. Emancipated minors are an exception to the minor rule, as they can provide consent for their own treatment.

2. Upon arrival at the emergency room, the client presents with severe burns to the left arm, hands, face, and neck. What action should take priority?

• A. Starting an IV
• B. Applying oxygen
• C. Obtaining blood gases
• D. Medicating the client for pain

Correct answer: B

Rationale: In a client with severe burns to the face and neck, airway assessment and supplemental oxygen are crucial. Therefore, applying oxygen is the priority to ensure adequate oxygenation for the client. This intervention takes precedence over other actions to stabilize the client's condition. Starting an IV for fluid resuscitation is the next appropriate step following ensuring oxygenation (Choice A). While pain management is important, it is a secondary priority after ensuring oxygenation and fluid resuscitation, making medicating the client for pain a later intervention (Choice D). Obtaining blood gases (Choice C) is not the immediate priority in this scenario and would typically be ordered by the healthcare provider based on the client's condition and response to initial interventions.

3. A home health nurse is planning for her daily visits. Which client should the home health nurse visit first?

• A. A client with AIDS being treated with Foscarnet
• B. A client with a fractured femur in a long leg cast
• C. A client with laryngeal cancer with a laryngectomy
• D. A client with diabetic ulcers on the left foot

Correct answer: C

Rationale: The correct answer is the client with laryngeal cancer who had a laryngectomy. This client is at risk for airway obstruction due to the surgical procedure, making it a priority visit. Clients with AIDS (choice A), a fractured femur (choice B), and diabetic ulcers (choice D) do not have immediate life-threatening conditions that require urgent attention compared to a client with a recent laryngectomy.

4. Fat emulsions are frequently administered as a part of total parenteral nutrition. Which statement is true regarding fat emulsions?

• A. They have a high energy-to-fluid-volume ratio.
• B. Even though hypertonic, they are well tolerated.
• C. They are a basic solution due to the addition of sodium hydroxide (NaOH).
• D. The pH is alkaline, making them compatible with most medications.

Correct answer: A

Rationale: The correct statement is that fat emulsions have a high energy-to-fluid-volume ratio. Fat emulsions are formulated in 10%, 20%, and 30% solutions and supply 1.1, 2, and 3 kilocalories, respectively, for each milliliter. In comparison, a milliliter of 5% dextrose only supplies 0.17 kilocalories. Choices B, C, and D are incorrect. Choice B is false because fat emulsions are essentially pH neutral and isotonic, not hypertonic. Choice C is incorrect because fat emulsions are not basic solutions; they are essentially pH neutral. Choice D is incorrect as fat emulsions are not alkaline; they are pH neutral, making them compatible with most medications.

5. What is the primary goal of family education?

• A. symptom reduction
• B. improved quality of life
• C. increased knowledge about mental illness
• D. improved caregiving skills

Correct answer: B

Rationale: The primary goal of family education is to improve the quality of life. Family education aims to enhance the overall well-being and functioning of both the individual with the condition and their family members. While increased knowledge about mental illness may be a beneficial outcome, it is not the primary objective of family education. Symptom reduction is more commonly associated with psychoeducation rather than family education. Improving caregiving skills is a component of family education, but the primary focus is on improving the quality of life for everyone involved in the caregiving process.

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