Nursing Elites

1. All of the following interventions should be performed when fetal heart monitoring indicates fetal distress except:

• A. Increase maternal fluids.
• B. Administer oxygen.
• C. Decrease maternal fluids.
• D. Turn the mother.

Correct answer: C

Rationale: When fetal heart monitoring indicates fetal distress, interventions are aimed at improving oxygenation to the fetus. Increasing maternal fluids helps improve placental perfusion and oxygen delivery to the fetus. Administering oxygen also aids in increasing oxygen supply to the fetus. Turning the mother can help relieve pressure on the vena cava, optimizing blood flow to the placenta. Therefore, decreasing maternal fluids would not be performed as it can further compromise placental perfusion and fetal oxygenation, making it the exception. Decreasing maternal fluids could potentially exacerbate fetal distress by reducing oxygen delivery and nutrient supply to the fetus, which is contrary to the goal of managing fetal distress.

2. An LPN is talking with a client scheduled to undergo a vasectomy in the next few minutes. He states, "I know I signed the form and all, but I'm not feeling so sure of this. It can be reversed pretty easily, right?"? What is the LPN's best response?

• A. "Yes, vasectomies can be reversed, but once you have it, you may regret it later."?
• B. "It's normal to feel a little nervous before a procedure like this."?
• C. "It sounds like you have a few more questions you'd like answered. Let me grab the doctor quickly so he can answer them for you."?
• D. "It sounds like you might be a little nervous. Don't worry, this is a pretty minor procedure, and the doctor doing it is the best we have. You're in great hands."?

Correct answer: C

Rationale: The best response for the LPN is to acknowledge the client's concerns and offer to provide more information. By offering to get the doctor to answer any additional questions, the LPN shows respect for the client's right to informed consent. Option A provides some information but dismisses the client's uncertainty and implies they won't regret the decision, which may not be the case. Option B acknowledges nervousness but doesn't directly address the client's request for more information. Option D attempts to reassure the client but fails to address the need for additional questions to be answered by the doctor.

3. A client admitted to the hospital has a do-not-resuscitate (DNR) order in his medical record. The nurse understands which information about DNR orders?

• A. The only individuals who may change the DNR order are healthcare providers
• B. The DNR order can be changed if the client's condition warrants it
• C. The DNR order does not remain fixed for the duration of the client's hospitalization
• D. The DNR order requires frequent review as specified by state or agency policy

Correct answer: D

Rationale: The correct answer is that the DNR order requires frequent review as specified by state or agency policy. If the client's condition changes, the DNR order may need to be changed. For this reason, DNR orders require frequent review as specified by state or agency policy. A DNR order may be changed at any time and does not remain in effect for the duration of the client's hospitalization. The client's request regarding DNR status is the priority. Choice A is incorrect because healthcare providers, not just immediate family members, may change the DNR order based on the client's condition. Choice B is incorrect as DNR orders can be changed if the client's condition warrants it, not remaining unchanged. Choice C is incorrect as DNR orders are not fixed for the duration of hospitalization, they can be modified based on the client's needs.

4. What is involved in client education by the nurse?

• A. Telling the client everything about their disease, what will happen in the course of the disease, and the outcome.
• B. Giving information to the client that is accurate and understandable.
• C. Informing the client that the pain they experience might not be real.
• D. Administering medication to the client when they experience pain.

Correct answer: B

Rationale: Client education by the nurse involves providing accurate and understandable information to the client. It is essential to offer relevant details without overwhelming them, making choice B the correct answer. Choice A is incorrect because providing excessive details can confuse the client rather than empower them with necessary knowledge. Choice C is incorrect as it is not the role of the nurse to question the reality of a client's pain; instead, they should address and manage the pain effectively. Choice D is incorrect as client education focuses on providing information and empowering clients with knowledge, not just administering medication.

5. The LPN is preparing to clean a client's PEG tube.The following tasks should the nurse perform EXCEPT?

• A. Gently remove crusty drainage from the site.
• B. Pull the tube in multiple directions to ensure it is secure.
• C. Thoroughly dry the skin around the tube site with a clean towel.
• D. Use mild soap to clean around the tube site.

Correct answer: B

Rationale: When cleaning a client's PEG tube, the nurse should perform tasks that focus on gentle cleaning and avoiding potential irritants. Choice A is correct as gently removing crusty drainage helps maintain hygiene. Choice C is important to prevent skin irritation and infection. Choice D is appropriate for cleaning the area. Choices B and D are incorrect. Choice B is incorrect because pulling the tube in multiple directions can lead to dislodgement or injury. Choice B is incorrect as talcum powder may irritate the stoma, and it is generally not recommended near PEG tubes.

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