Nursing Elites

1. A client scheduled for surgery tells the nurse that he signed an informed consent for the surgical procedure but was never told about the risks of the surgery. The nurse serves as the client's advocate by undertaking which action?

• A. Reassuring the client that the risks are minimal
• B. Noting in the client's record that the client was not told about the risks of the surgery
• C. Writing a note on the front of the client's record so that the surgeon will see it when the client arrives in the operating room
• D. Informing the surgeon verbally about the lack of information provided to the client

Correct answer: B

Rationale: A nurse serves as a client advocate by protecting the client's right to be informed and to participate in decisions regarding care. In this scenario, the nurse should document in the client's record that the client was not informed about the risks of the surgery. This action ensures that the issue is officially noted and can be addressed by the healthcare team. Reassuring the client that the risks are minimal is incorrect because it dismisses the client's concerns and does not address the lack of information provided. Writing a note on the client's chart to inform the surgeon is not as effective as ensuring that the issue is officially documented in the client's record, where it can be reviewed and addressed by the healthcare team. Informing the surgeon verbally is not as reliable as documenting the concern in the client's record, which provides a formal and lasting record for review and follow-up.

2. Which of the following is not a function of parathyroid hormone?

• A. moving calcium from bones to the bloodstream
• B. inhibiting renal tubular reabsorption of phosphorus
• C. promoting renal tubular reabsorption of calcium
• D. enhancing renal production of vitamin D metabolites

Correct answer: B

Rationale: The correct answer is 'inhibiting renal tubular reabsorption of phosphorus.' Parathyroid hormone actually inhibits renal tubular reabsorption of phosphorus, making this choice the opposite of its function. Parathyroid hormone functions to move calcium from bones to the bloodstream (Choice A), promote renal tubular reabsorption of calcium (Choice C), and enhance renal production of vitamin D metabolites (Choice D). Therefore, all other choices are functions of parathyroid hormone except for the inhibition of phosphorus reabsorption.

3. Which of the following tasks are appropriate for an LPN to perform?

• A. Adjusting the cervical traction device of a 68-year-old client as instructed by the charge nurse.
• B. performing operation on a woman in labour
• C. Assessing a 36-year-old man newly admitted for chest pain.
• D. Obtaining an occult blood sample from a 16-year-old client with ulcerative colitis.

Correct answer: D

Rationale: Tasks appropriate for an LPN to perform include teaching, obtaining samples, and documenting. LPNs can educate clients on care practices, such as teaching a new mother how to care for her baby. Obtaining samples, like an occult blood sample, falls within the scope of an LPN's responsibilities. Assessments, especially initial assessments, should be conducted by a registered nurse or physician, making option C incorrect. Adjusting devices like a cervical traction device should be done based on direct orders from prescribing providers, not charge nurses, making option A inappropriate for an LPN's role.

4. Which is the proper hand position for performing chest percussion?

• A. Use the side of the hands
• B. Flatten the hands
• C. Spread the fingers of both hands
• D. Cup the hands

Correct answer: D

Rationale: The proper hand position for performing chest percussion is to cup the hands. Cupping the hands helps produce a vibration that aids in loosening respiratory secretions effectively. This technique is essential for therapeutic chest physiotherapy. Using the side of the hands, flattening the hands, or spreading the fingers of both hands do not generate the necessary vibration required for chest percussion. These hand positions are not considered proper techniques in this context and may not provide the desired therapeutic effect.

5. Following a recent tattoo, someone should be screened for:

• A. tuberculosis.
• B. herpes.
• C. hepatitis.
• D. syphilis.

Correct answer: C

Rationale: Following a recent tattoo, someone should be screened for hepatitis. Tattooing puts a client at risk for blood-borne hepatitis B or C if strict sterile procedures are not followed. Tuberculosis is an airborne pathogen, while herpes and syphilis are spread through direct contact like sexual activity. Therefore, hepatitis is the most relevant infection to screen for after getting a tattoo.

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