Nursing Elites

1. A client who decides not to have surgery despite significant blockages in his coronary arteries is an example of what principle?

• A. Fidelity
• B. Autonomy
• C. Justice
• D. Non-maleficence

Correct answer: B

Rationale: The correct answer is B: Autonomy. Autonomy in healthcare refers to respecting a patient's right to make decisions about their own care, even if those decisions may not align with healthcare providers' recommendations. In this scenario, the client's decision not to have surgery despite significant blockages in his coronary arteries demonstrates his autonomy in making choices about his own health. Choice A, Fidelity, refers to the concept of keeping promises and being faithful to commitments, which is not applicable in this situation. Choice C, Justice, involves fairness and equal treatment in healthcare, which is not the primary principle at play when a patient exercises autonomy. Choice D, Non-maleficence, relates to the principle of doing no harm, which is important but not directly relevant to the client's decision to refuse surgery.

2. Which of the following is an early indicator that a client with a tracheostomy may require suctioning?

• A. Decreased respiratory rate
• B. Irritability
• C. Bradycardia
• D. Decreased oxygen saturation

Correct answer: B

Rationale: Irritability is an early indicator that suctioning is necessary for a client with a tracheostomy. Irritability can signal discomfort or difficulty breathing, which may be due to the need for suctioning to clear the airway. Decreased respiratory rate, bradycardia, and decreased oxygen saturation are not typically early indicators that suctioning is needed in a client with a tracheostomy. These symptoms may occur later if the airway is not cleared promptly.

3. A public health nurse working in a rural area is developing a program to improve health for the local population. Which of the following actions should the nurse plan to take?

• A. Provide anticipatory guidance classes to parents through public schools.
• B. Have a nurse from outside the community provide health lectures at the county hospital.
• C. Encourage rural residents to focus health spending on tertiary health interventions.
• D. Launch a media campaign to increase awareness about industrial pollution.

Correct answer: A

Rationale: Providing anticipatory guidance classes to parents through public schools is the most appropriate action for the public health nurse in a rural area. This approach allows the nurse to address early prevention strategies, which are crucial in promoting health in rural populations. Choice B is incorrect because having a nurse from outside the community may not fully understand the local needs and dynamics. Choice C is wrong as focusing health spending on tertiary interventions is not cost-effective or preventive. Choice D is also incorrect because while increasing awareness about industrial pollution is important, it may not directly address the health needs of the local rural population.

4. A client who is immobile needs interventions to prevent contractures. Which of the following interventions is appropriate?

• A. Aligning a trochanter wedge between the client's legs.
• B. Placing a towel roll under the client's neck.
• C. Applying an orthotic to the client's foot.
• D. Positioning a pillow under the client's knees.

Correct answer: C

Rationale: Applying an orthotic to the client's foot is the appropriate intervention to prevent contractures in an immobile client. An orthotic helps maintain proper alignment and prevents the development of contractures by keeping the foot in the correct position. Choices A, B, and D are incorrect because a trochanter wedge, towel roll under the neck, and pillow under the knees are not specific interventions for preventing contractures in an immobile client.

5. A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following actions should the nurse take to promote wound healing?

• A. Apply heat to the surgical site
• B. Ensure the client consumes adequate protein
• C. Encourage the client to ambulate frequently
• D. Instruct the client to drink 4 liters of water daily

Correct answer: B

Rationale: The correct answer is to ensure the client consumes adequate protein. Protein is essential for wound healing as it supports tissue repair. Applying heat to the surgical site (choice A) is not recommended as it can increase inflammation. Although ambulation (choice C) is beneficial for circulation and preventing complications, it is not directly related to promoting wound healing. Instructing the client to drink 4 liters of water daily (choice D) is excessive and not specifically related to wound healing in this context.

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