Nursing Elites

1. While caring for the following clients, a pediatric nurse tells the charge nurse she must leave due to a family emergency. Which client would the charge nurse reassign to an LPN?

• A. An eight-year-old in diabetic ketoacidosis
• B. A six-year-old in sickle cell crisis
• C. A two-month-old with dehydration
• D. A five-year-old in skeletal traction

Correct answer: D

Rationale: The correct answer is a five-year-old in skeletal traction. This task is within the scope of practice for an LPN and would need minimal assistance from an RN. The children with diabetic ketoacidosis, sickle cell crisis, and dehydration require close observation, good assessment skills, IVF needs, and medications that would be better managed by an RN. Reassigning the child in skeletal traction to an LPN ensures appropriate care while allowing the RN to focus on the more critical cases.

2. Which of the following syndromes associated with incomplete lesions of the spinal cord results from damage to one-half of the spinal cord?

• A.
• B. posterior cord syndrome
• C. central cord syndrome
• D. cauda equina syndrome

Correct answer: A

Rationale:

3. Ethical and moral issues concerning restraints include all of the following except:

• A. emotional impact on the client and family.
• B. dignity of the client.
• C. client's quality of life.
• D. policies and procedures.

Correct answer: D

Rationale: The correct answer is 'policies and procedures.' While policies and procedures are essential for managing restraints, they are not in themselves ethical or moral issues. The emotional impact on the client and family, the dignity of the client, and the client's quality of life are all ethical and moral concerns related to the use of restraints. These aspects focus on the well-being, respect, and rights of the individual, which are fundamental ethical considerations in healthcare practice. Choices A, B, and C are directly tied to ethical and moral considerations by highlighting the impact on individuals involved and their overall quality of life and dignity, making them key factors to address in ethical decision-making.

4. A nursing assistant who has been employed in the long-term care center for 8 weeks is consistently taking extended lunch breaks. The nursing assistant's behavior has caused problems with client care during lunch hours. What is the appropriate way for the nurse to deal with this situation?

• A. Ignoring the situation
• B. Documenting the problem in the nursing assistant's personnel file
• C. Asking other staff members to cover for the nursing assistant
• D. Meeting with the nursing assistant to discuss the behavior and initiate problem-solving measures

Correct answer: D

Rationale: Taking extended lunch breaks is an unacceptable behavior, especially when it affects client care. The appropriate way for the nurse to deal with this situation is to meet with the nursing assistant to discuss the behavior and initiate problem-solving measures. This direct approach allows for open communication and the opportunity to address the issue effectively. Ignoring the situation (Choice A), asking other staff members to cover (Choice C), or documenting the problem in the nursing assistant's personnel file (Choice B) are not effective solutions. Ignoring the behavior does not address the issue, asking others to cover may not solve the problem at its root, and documenting the problem should come after attempting to resolve the issue through communication and problem-solving first.

5. What is a significant point about Shigella that the nurse should acknowledge upon identifying it in a stool culture?

• A. People who have been in contact with the client need to be tested.
• B. Shigella is an airborne infection.
• C. Shigella is a bacteria sometimes found in stagnant water.
• D. The nurse should wear a one-way breathing apparatus when giving client care.

Correct answer: C

Rationale: Shigella is a bacteria sometimes found in stagnant water. Transmission of Shigella is typically oral-fecal, so good hand washing and the use of gloves are the best means of prevention when caring for a client with Shigella. The bacteria can be found in food and water contaminated by fecal material. Incidences of Shigella are reportable in many states. Choices A, B, and D are incorrect. While it is important for close contacts to be aware and practice good hygiene, testing is not routinely indicated. Shigella is not an airborne infection; it is transmitted through contaminated food or water. A one-way breathing apparatus is not necessary for caring for a patient with Shigella; standard precautions, including handwashing and gloves, are sufficient.

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