Nursing Elites

1. A nurse at an assisted living facility is preparing an in-service for residents about electrical safety. Which of the following instructions should the nurse include?

• A. Avoid taping electrical cords to the floor.
• B. Clean electrical equipment before disconnection.
• C. Cover exposed wires with tape before use.
• D. Disconnect electrical equipment by grasping the plug.

Correct answer: A

Rationale: The correct instruction for electrical safety is to avoid taping electrical cords to the floor. Taping cords can create tripping hazards, leading to falls and potential injuries. Choice B, cleaning electrical equipment before disconnection, is not directly related to electrical safety but rather to equipment maintenance. Choice C, covering exposed wires with tape before use, is incorrect as exposed wires should be properly insulated and repaired by a qualified professional. Choice D, disconnecting electrical equipment by grasping the plug, is unsafe and can lead to electrical shocks. It is always recommended to unplug devices by holding the plug itself, not by pulling the cord.

2. When assisting an 82-year-old client to ambulate, it is important for the LPN/LVN to realize that the center of gravity for an elderly person is in the

• A. Arms.
• B. Upper torso.
• C. Head.
• D. Feet.

Correct answer: B

Rationale: The correct answer is 'Upper torso.' In elderly individuals, the center of gravity tends to shift upwards towards the upper torso due to various factors such as changes in posture and muscle strength. Understanding this is crucial for safe ambulation as it helps in maintaining balance and stability. Choices A, 'Arms,' C, 'Head,' and D, 'Feet,' are incorrect. The center of gravity is not typically located in the arms, head, or feet. It is higher up in the body, specifically in the upper torso. Knowing the correct location of the center of gravity is essential for assisting elderly clients in ambulation effectively and preventing falls.

3. How should a healthcare professional care for a client approaching death with shortness of breath and noisy respirations?

• A. Turn the client every 2 hours
• B. Provide supplemental oxygen
• C. Use a fan to reduce the feeling of breathlessness
• D. Administer diuretics as prescribed

Correct answer: C

Rationale: In a palliative care setting, when caring for a client approaching death with symptoms of shortness of breath and noisy respirations, using a fan can help alleviate the sensation of breathlessness. This intervention can provide comfort by improving air circulation and reducing the perception of breathlessness. Turning the client every 2 hours may not directly address the respiratory distress caused by noisy respirations. Providing supplemental oxygen may not be indicated or effective in all cases, especially in end-of-life care where the focus is on comfort rather than aggressive interventions. Administering diuretics as prescribed would not be appropriate for addressing noisy respirations and shortness of breath in a dying client, as this may not be related to fluid overload or congestion. Therefore, the most appropriate action to help the client feel more comfortable in this situation is to use a fan to reduce the feeling of breathlessness.

4. A nurse is providing education about cultural and religious traditions and rituals related to death for the assistive personnel on the unit. Which of the following information should the nurse include?

• A. People who practice Judaism stay with the body of the deceased until burial.
• B. People who practice Islam avoid cremation of the body.
• C. People who practice Buddhism prefer to have a brief funeral service.
• D. People who practice Hinduism prefer to have the body embalmed before cremation.

Correct answer: A

Rationale: The correct answer is A. In Judaism, it is customary for the body to be attended to by family or members of the community until burial. This practice is rooted in the belief of providing respect and care to the deceased individual. Choices B, C, and D are incorrect because they do not accurately reflect the cultural and religious traditions related to death for people who practice Islam, Buddhism, and Hinduism, respectively. People who practice Islam generally avoid cremation and opt for burial, Buddhists may have varying funeral service preferences, and Hindus often practice cremation without embalming the body.

5. A nurse on a med-surg unit is providing care for four clients. The nurse should identify which of the following situations as an ethical dilemma?

• A. A surgeon who removed the wrong kidney during a surgical procedure refuses to take responsibility for her actions
• B. A client who has a new colostomy refuses to follow instructions from the ostomy therapist because she 'doesn’t like him'
• C. The family of a client who has a terminal illness asks that the provider not disclose the diagnosis to the client
• D. A client who has Crohn’s disease reports that his prescription drug plan will not cover his medications

Correct answer: C

Rationale: The correct answer is C. It is an ethical dilemma when the family of a client with a terminal illness asks healthcare providers not to inform the client of their diagnosis. This situation poses a conflict between respecting the client's right to know the truth about their condition (autonomy and truth-telling principles) and honoring the family's wishes. Choices A, B, and D do not present ethical dilemmas. Choice A involves professional accountability and responsibility, Choice B involves a client's personal preference, and Choice D involves financial challenges.

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