Nursing Elites

1. A female Native American client who is receiving chemotherapy places a native artifact, an Indian medicine wheel, in her hospital room. The HCP removes the medicine wheel and tells the client, 'This type of thing does not belong in the hospital.' Which intervention should the PN implement?

• A. Teach the client about the importance of adhering to the chemotherapy regimen
• B. Act as the client's advocate when addressing the issue with the HCP
• C. Consult with a Native American healer about the appropriate use of a medicine wheel
• D. Inform the HCP about the client's feelings of culture shock

Correct answer: B

Rationale: Acting as the client's advocate is the most appropriate intervention in this situation. Removing a culturally significant artifact without considering the client's beliefs and emotional needs can be distressing. By advocating for the client, the PN can ensure that the client's cultural practices are respected, which is crucial for her emotional and spiritual well-being during treatment. Choice A is incorrect because while chemotherapy adherence is important, it is not the most immediate concern in this scenario. The client's cultural needs and well-being take precedence. Choice C is incorrect because consulting with a Native American healer might not be necessary at this point and could delay addressing the immediate issue of advocating for the client's rights. Choice D is incorrect because simply reporting the client's feelings of culture shock to the HCP does not actively address the situation or advocate for the client's rights and cultural needs.

2. During a fire incident in a long-term care facility's kitchen, which task is most crucial for the PN to perform instead of delegating to UAP?

• A. Close the doors to all residents' rooms
• B. Offer comfort and reassurance to each resident
• C. Identify the method for transporting and evacuating each resident
• D. Provide blankets to each resident for use during evacuation

Correct answer: C

Rationale: During a fire emergency, the most critical task for the PN is to identify the method for transporting and evacuating each resident. This task ensures a safe and organized evacuation plan, which is essential for everyone's safety. Delegating this responsibility to an unlicensed assistive personnel (UAP) may lead to errors or delays in the evacuation process. Closing doors to residents' rooms (Choice A) can help contain the fire but is not as urgent as planning the evacuation. While offering comfort and reassurance (Choice B) is important, it should not take precedence over ensuring a safe evacuation. Providing blankets (Choice D) is helpful but does not directly address the primary concern of safely evacuating residents.

3. After spinal fusion surgery, a client reports numbness and tingling in the legs. What should the nurse do first?

• A. Assess the client’s neurovascular status in the lower extremities.
• B. Reposition the client to relieve pressure on the spine.
• C. Administer prescribed pain medication.
• D. Notify the healthcare provider immediately.

Correct answer: A

Rationale: After spinal fusion surgery, numbness and tingling in the legs may indicate nerve compression or damage. The priority action for the nurse is to assess the client’s neurovascular status in the lower extremities. This assessment will help determine the cause and severity of the symptoms, guiding further interventions. Repositioning the client may be necessary for comfort, but assessing neurovascular status is the initial step. Administering pain medication should only follow the assessment to address any discomfort. Notifying the healthcare provider immediately is not the first action unless there are emergent signs requiring urgent intervention.

4. Which of the following components of nutrition has a primary function of helping with tissue growth and repair?

• A. Vitamin D
• B. Vitamin E
• C. Protein
• D. Fat

Correct answer: C

Rationale: Protein is the correct answer as it is essential for tissue growth and repair. Proteins are composed of amino acids, the building blocks of body tissues. While vitamins D and E have important roles in the body, they are not primarily responsible for tissue growth and repair. Fats are crucial for various bodily functions, like providing energy, but they are not the primary component involved in tissue growth and repair.

5. A male client who has been diagnosed with schizophrenia is withdrawn, isolates himself in the day room, and answers questions with one or two-word responses. This morning, the practical nurse observes that he is diaphoretic and is pacing in the hall. Which intervention is most important for the PN to implement?

• A. Persuade the client to lie down
• B. Provide a drink high in electrolytes
• C. Observe the client during the shift
• D. Measure appropriate vital signs

Correct answer: D

Rationale: Measuring vital signs is crucial in this situation as it helps to determine if the client is experiencing a physical health issue or if the symptoms are related to a mental health crisis, such as anxiety or agitation. The presence of diaphoresis and pacing may indicate physiological changes requiring immediate attention. Providing a drink high in electrolytes or persuading the client to lie down may not address the underlying cause of the symptoms. Simply observing the client during the shift without taking necessary actions to assess his physiological status may delay appropriate intervention.

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