Nursing Elites

1. A nurse is caring for a group of clients on a medical-surgical unit. In which of the following situations does the nurse demonstrate the ethical principle of veracity?

• A. A client unaware of her recent cancer diagnosis asks the nurse if she has cancer, and the nurse responds affirmatively.
• B. The nurse avoids discussing the client's diagnosis to prevent emotional distress.
• C. The nurse provides a vague answer about the client's condition.
• D. The nurse promises to provide information only if it is requested by the client.

Correct answer: A

Rationale: Veracity involves telling the truth, a fundamental ethical principle in healthcare. In this scenario, the nurse demonstrates veracity by responding honestly when the client directly asks about her cancer diagnosis. Choice B is incorrect as avoiding discussing the diagnosis to prevent emotional distress does not align with veracity and transparency. Choice C is incorrect as providing a vague answer does not uphold the principle of truthfulness. Choice D is incorrect because promising to provide information only upon client request does not address the immediate question about the cancer diagnosis and lacks transparency.

2. A 3-year-old child is brought to the clinic by his grandmother to be seen for 'scratching his bottom and wetting the bed at night.' Based on these complaints, the nurse would initially assess for which problem?

• A. Allergies
• B. Scabies
• C. Regression
• D. Pinworms

Correct answer: D

Rationale: The correct answer is D, Pinworms. Pinworms are a common cause of itching around the anal area, especially at night, in young children. Scratching the bottom and bedwetting can be indicative of a pinworm infection. Allergies (Choice A) are less likely given the symptoms described. Scabies (Choice B) may cause itching but is less common in causing bedwetting. Regression (Choice C) is not a common cause of these specific symptoms in a 3-year-old child.

3. A nurse on a medical-surgical unit is admitting a client. Which of the following information should the nurse document in the client’s record first?

• A. Assessment
• B. History of present illness
• C. Plan of care
• D. Admission date and time

Correct answer: D

Rationale: When admitting a client to a medical-surgical unit, documenting the admission date and time is crucial as it establishes the timeline for the client's care. This information ensures accurate tracking of interventions and facilitates communication among the healthcare team. While assessment, history of present illness, and plan of care are important components of the admission process, documenting the admission date and time takes priority to establish a baseline for care delivery. Without the admission date and time, the continuity of care and coordination among healthcare providers may be compromised.

4. A nurse educator is conducting a parenting class for new guardians of infants. Which of the following statements made by a participant indicated understanding?

• A. “I will set my water heater at 130°F.”
• B. “Once my baby can sit up, they should be safe in the bathtub.”
• C. “I will place my baby on their stomach to sleep.”
• D. “Once my infant starts to push up, I will remove the mobile from over the crib.”

Correct answer: D

Rationale: The correct answer is D. Removing the mobile when the baby starts to push up prevents choking hazards as infants can reach and grab objects posing a risk of choking. Choice A is unsafe as setting the water heater at 130°F can scald a child. Choice B is incorrect because even when a baby can sit up, they still require close supervision in the bathtub. Choice C is unsafe as current guidelines recommend placing babies on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). Therefore, choices A, B, and C are incorrect or unsafe practices for infant care.

5. A client with chronic renal failure selects scrambled eggs for breakfast. What action should the LPN/LVN take?

• A. Commend the client for selecting a high biological value protein.
• B. Remind the client that protein in the diet should be avoided.
• C. Suggest that the client also select orange juice to promote absorption.
• D. Encourage the client to attend classes on dietary management of chronic renal failure.

Correct answer: A

Rationale: The correct action is to commend the client for selecting a high biological value protein, as scrambled eggs provide a good protein source for clients with chronic renal failure. Protein is essential for maintaining muscle mass and overall health in these clients. Reminding the client to avoid protein is incorrect as it may lead to protein-energy malnutrition, which is a common concern in chronic renal failure. Suggesting orange juice for absorption is not relevant to the situation, as protein absorption is not a primary concern in this context. Encouraging the client to attend classes on dietary management of chronic renal failure is important for overall education but is not the immediate action needed in response to the client's breakfast choice.

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