Nursing Elites

1. When caring for a client in the advanced stage of amyotrophic lateral sclerosis (ALS), which of the following referrals is the nurse's priority?

• A. Psychologist
• B. Social worker
• C. Occupational therapist
• D. Speech-language pathologist

Correct answer: D

Rationale: In the advanced stage of ALS, speech and swallowing difficulties become significant. As a result, the priority referral for the nurse would be a speech-language pathologist. This professional can assist in managing communication challenges and provide strategies to address swallowing issues, ensuring the client's safety and quality of life.

2. When caring for a toddler with acute lymphocytic leukemia, in which of the following activities should the toddler participate?

• A. Looking at alphabet flashcards.
• B. Playing with a large plastic truck.
• C. Using scissors to cut out paper shapes.
• D. Watching a cartoon in the dayroom.

Correct answer: B

Rationale: Toddlers with acute lymphocytic leukemia may have compromised immune systems and need to avoid activities that increase infection risk. Playing with a large plastic truck is a safe and engaging activity that does not pose a high risk of infection. This choice also promotes physical activity and creativity, which are beneficial for a toddler's development during illness.

3. A client has diaper dermatitis. Which of the following actions should the nurse take?

• A. Apply zinc oxide ointment to the irritated area.
• B. Wipe stool from the skin using store-bought baby wipes.
• C. Apply talcum powder to the irritated area.
• D. None of the above

Correct answer: A

Rationale: Diaper dermatitis, also known as diaper rash, is a common condition in babies or clients who wear diapers. The primary intervention for diaper dermatitis is to apply a protective barrier cream, such as zinc oxide ointment, to the irritated area. This helps to protect the skin from irritants and promotes healing. Wiping stool from the skin using baby wipes may further irritate the skin, and talcum powder is no longer recommended due to potential respiratory risks when inhaled. Therefore, the correct action for the nurse in this scenario is to apply zinc oxide ointment to the irritated area.

4. Which of the following conditions in the client's history is a contraindication to the use of oral contraceptives?

• A. Hyperthyroidism.
• B. Thrombophlebitis.
• C. Diverticulosis.
• D. Hypocalcemia.

Correct answer: B

Rationale: Thrombophlebitis, which is inflammation of a vein with the formation of a clot, is a contraindication to the use of oral contraceptives due to an increased risk of thromboembolism. Clients with a history of thrombophlebitis or thromboembolic disorders should avoid oral contraceptives to prevent further complications like deep vein thrombosis or pulmonary embolism.

5. A client requests the creation of a living will. Which of the following actions should the nurse take?

• A. Schedule a meeting between the hospital ethics committee and the client.
• B. Evaluate the client's understanding of life-sustaining measures.
• C. Determine the client's preferences about post-mortem care.
• D. Request a conference with the client's family

Correct answer: B

Rationale: When a client requests the creation of a living will, the nurse's priority is to evaluate the client's understanding of life-sustaining measures. This involves ensuring that the client comprehends the implications of various life-sustaining interventions and can make informed decisions about their care preferences in the event they are unable to communicate them later. It is crucial for the nurse to assess the client's comprehension to ensure that the living will accurately reflects the client's wishes and values.

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