Nursing Elites

1. A client with a tumor refuses surgery, but the client's partner wants it. Which is the deciding factor in determining if the surgery will be done?

• A. Whether the partner is the client's durable power of attorney for healthcare
• B. Whether the client understands the risk of refusing the procedure
• C. Whether the client's refusal is based on religious belief
• D. Whether the facility's ethical committee reaches a consensus on the case

Correct answer: B

Rationale: The correct answer is B because the client's understanding of the risks involved in refusing the surgery is crucial in determining the course of action. In this scenario, the client's autonomy and decision-making capacity take precedence. Choice A is not directly relevant to the decision-making process regarding surgery. Choice C, religious beliefs, may influence the decision but should not be the determining factor in this case. Choice D involving the facility's ethical committee is not typically involved in individual patient care decisions.

2. A nurse is assessing a client who has meningitis. Which of the following findings should the nurse report to the provider immediately?

• A. Generalized rash over trunk
• B. Increased temperature
• C. Decreased level of consciousness
• D. Report of photophobia

Correct answer: C

Rationale: The correct answer is C: Decreased level of consciousness. In a client with meningitis, a decreased level of consciousness is a critical finding that should be reported immediately. This could indicate increased intracranial pressure or neurological deterioration, requiring prompt intervention. Choices A, B, and D are important in the assessment of meningitis but are not as immediately concerning as a decreased level of consciousness. A generalized rash over the trunk can be seen in meningococcal meningitis, an increased temperature is expected due to the inflammatory response, and photophobia is a common symptom due to meningeal irritation.

3. A nurse is providing an in-service about client rights for a group of nurses. Which of the following statements should the nurse include in the service?

• A. A nurse can disclose information to a family member with the client's permission
• B. A nurse can apply restraints on an as-needed basis
• C. A nurse can administer medications without consent to a client as part of a research study
• D. A nurse is responsible for informing clients about treatment options

Correct answer: A

Rationale: The correct statement to include in the in-service about client rights is that a nurse can disclose information to a family member with the client's permission. This respects the client's autonomy and privacy. Choice B is incorrect because restraints should only be applied based on a specific assessment and order, not on an as-needed basis. Choice C is incorrect as administering medications without consent is a violation of ethical principles and legal standards. Choice D is incorrect because while nurses should educate clients about treatment options, the ultimate decision lies with the client after being informed.

4. What is the role of a nurse in patient education?

• A. Providing patients with necessary information to manage their health
• B. Limiting information to prevent confusion
• C. Using complex medical terminology
• D. Discouraging questions from patients

Correct answer: A

Rationale: The correct answer is A: Providing patients with necessary information to manage their health. Nurses play a crucial role in patient education by offering essential information to help patients understand and manage their health conditions. This empowers patients to make informed decisions about their health and improve their overall well-being. Choices B, C, and D are incorrect. Limiting information would hinder patient understanding and decision-making, using complex medical terminology can confuse patients, and discouraging questions goes against the essence of patient education.

5. A client with DM has an above-knee amputation because of severe peripheral vascular disease. Two days following surgery, when preparing the client for dinner, what is the nurse's primary responsibility?

• A. Check the client's serum glucose level
• B. Assist the client out of bed to the chair
• C. Place the client in a high-Fowler's position
• D. Ensure that the client's residual limb is elevated

Correct answer: A

Rationale: The correct answer is to check the client's serum glucose level. In a client with diabetes who just had surgery, monitoring the serum glucose level is crucial to ensure proper management of the condition. This helps in preventing complications related to blood sugar fluctuations. Assisting the client out of bed may be important but not the primary responsibility at this time. Placing the client in a high-Fowler's position or ensuring the residual limb is elevated are important interventions for comfort and circulation but are not the primary concern in this scenario.

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