Nursing Elites

1. A client reports difficulty sleeping while in the hospital. Which of the following actions taken by the assistive personnel (AP) while the client is sleeping should prompt the nurse to intervene?

• A. Closes the door to the client's room
• B. Flushes the client's toilet after emptying the urinary catheter's drainage bag
• C. Measures the client's vital signs routinely
• D. Asks a group of personnel in the hall to speak quietly

Correct answer: B

Rationale: The correct answer is B because flushing the client's toilet after emptying the urinary catheter's drainage bag could disturb the client's rest. The nurse should intervene to ensure a restful environment for the client. Choices A, C, and D are not actions that would be disruptive to the client's sleep. Closing the door to the client's room, measuring vital signs routinely, and asking personnel in the hall to speak quietly are appropriate actions that do not directly disturb the client's rest.

2. A patient has a DNR (do-not-resuscitate) order but their family insists on resuscitation if necessary. What should the nurse do?

• A. Follow the family's wishes to resuscitate.
• B. Explain that the nurse must follow the DNR order.
• C. Ask the provider for clarification on the DNR.
• D. Call the ethics committee to discuss the situation.

Correct answer: B

Rationale: The correct answer is B. The nurse must follow the legal DNR order, even if the family insists on resuscitation. Respecting the patient's wishes is crucial in providing ethical care. Choice A is incorrect because the nurse should prioritize the patient's documented wishes over the family's requests. Choice C may cause unnecessary delays in care as the DNR order is a legal document. Choice D is not the initial action to take in this situation; the nurse should first address the conflict between the family's wishes and the patient's DNR order.

3. Which action by the nurse represents the ethical principle of beneficence?

• A. Ensuring all clients are treated fairly
• B. Preventing harm by providing accurate information
• C. Allowing the client to refuse treatment
• D. Ensuring the client's family agrees with the treatment

Correct answer: B

Rationale: The correct answer is B. Beneficence is the ethical principle of doing good or acting in the best interest of the client. Preventing harm by providing accurate information and necessary care aligns with the principle of beneficence, as it focuses on promoting the well-being and safety of the client. Choices A, C, and D do not directly reflect the concept of beneficence. Ensuring all clients are treated fairly relates more to justice, allowing the client to refuse treatment pertains to autonomy, and ensuring the client's family agrees with the treatment involves collaboration and communication but not specifically beneficence.

4. A healthcare provider is providing a report to a colleague about a client who weighs 210 lb and has a prescription for one-third weight bearing on the right leg. How many kg of weight should the client bear on the right leg?

• A. 32 kg
• B. 35 kg
• C. 40 kg
• D. 45 kg

Correct answer: A

Rationale: To calculate the weight-bearing limit, we first need to convert 210 lbs to kg. To do this, we use the conversion factor 1 lb = 0.453592 kg. So, 210 lbs is equal to 210 * 0.453592 = 95.254 kg. One-third of 95.254 kg is 31.7513 kg, which can be rounded to 32 kg. Therefore, the client should bear 32 kg of weight on the right leg. Choice A is the correct answer. Choices B, C, and D are incorrect as they do not reflect the accurate calculation based on the client's weight and the prescribed weight-bearing limit.

5. What is the most important nursing intervention when caring for a patient with a wound?

• A. Apply an occlusive dressing over the wound.
• B. Clean the wound with normal saline.
• C. Administer antibiotics as prescribed.
• D. Reassess the wound every 4 hours for changes.

Correct answer: B

Rationale: The most important nursing intervention when caring for a patient with a wound is to clean the wound with normal saline. This is crucial for preventing infection and promoting healing. Applying an occlusive dressing (Choice A) can be important but should come after cleaning the wound. Administering antibiotics (Choice C) is not the first-line intervention for all wounds and should be based on the healthcare provider's prescription. Reassessing the wound (Choice D) is essential but not the most important initial intervention.

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