Nursing Elites

1. A licensed practical nurse (LPN) works on an adult medical/surgical unit and has been pulled to work on the burn unit, which cares for clients of all ages. What should the LPN do?

• A. The LPN should take the assignment, but make it clear they will only care for adult clients.
• B. The LPN should take the assignment, but explain the situation to the charge nurse and ask for a quick orientation before starting.
• C. The LPN should refuse to take the assignment, as caring for the infant and child population is not within their scope of practice.
• D. The LPN should take the assignment, but ask to be paired with a more experienced LPN.

Correct answer: B

Rationale: In this scenario, it is crucial for the LPN to demonstrate flexibility and a willingness to adapt to the new assignment that involves caring for clients of all ages. While the LPN may have expertise in a specific nursing area, it is essential to be able to provide care to diverse client populations. Accepting the assignment reflects a commitment to teamwork and patient care. However, to ensure safe and competent care, the LPN should communicate with the charge nurse about the situation. Requesting a quick orientation will help the LPN familiarize themselves with the burn unit's specific requirements, equipment, and protocols. This proactive approach allows the LPN to address any concerns, ask questions, and seek necessary support, ultimately ensuring the best care for all clients in the burn unit. Choice A is incorrect because limiting care to only adult clients may not be feasible in a unit that cares for clients of all ages. Choice C is incorrect as refusing the assignment outright may not be the best approach without considering alternatives. Choice D is not the most effective option as asking to be paired with a more experienced LPN does not address the need for a quick orientation to the new unit.

2. Which of the following lab values is associated with a decreased risk of cardiovascular disease?

• A. high HDL cholesterol
• B. low HDL cholesterol
• C. low total cholesterol
• D. low triglycerides

Correct answer: A

Rationale: The correct answer is high HDL cholesterol. High HDL cholesterol levels are associated with a decreased risk of cardiovascular disease because HDL helps remove LDL cholesterol from the arteries, reducing plaque buildup. Low HDL cholesterol (choice B) is actually associated with an increased risk of cardiovascular disease. Low total cholesterol (choice C) or low triglycerides (choice D) are not indicators of a decreased risk of cardiovascular disease; in fact, extremely low total cholesterol levels may indicate other health issues.

3. The laws enacted by states to provide immunity from liability to persons who provide emergency care at an accident scene are called:

• A. Good Samaritan laws.
• B. HIPAA.
• C. Patient Self-Determination Act (PSDA).
• D. OBRA.

Correct answer: A

Rationale: The correct answer is Good Samaritan laws. These laws protect individuals who provide voluntary emergency care from being held liable for any unintended injury or harm that may occur during the care. Good Samaritan laws encourage individuals to assist in emergencies without fear of legal repercussions. HIPAA, on the other hand, focuses on safeguarding patient information and privacy, ensuring confidentiality. The Patient Self-Determination Act (PSDA) pertains to a patient's rights to make decisions about their medical treatment and advance directives. OBRA, enacted in the late 1980s, aims to improve the quality of care in nursing homes and enhance residents' quality of life, focusing on nursing home reform and standards, which is not directly related to immunity for emergency care providers.

4. What dietary alterations should a pregnant client with congenital heart disease expect?

• A. reduced calories and reduced fat
• B. caffeine and sodium restrictions
• C. decreased protein and increased complex carbohydrates
• D. fluid restriction and reduced calories

Correct answer: B

Rationale: In a pregnant client with congenital heart disease, caffeine should be restricted as it can increase heart rate, which is already under stress due to pregnancy. Sodium restrictions may be necessary to prevent fluid retention, which can worsen the client's heart condition. Decreasing calories, fat, protein, or fluid may not be appropriate as these can lead to nutrient deficiencies or inadequate energy intake, which is crucial during pregnancy. Therefore, options A, C, and D are not the expected dietary alterations in the client's diet during pregnancy with congenital heart disease.

5. The nurse is caring for a client recovering from a stroke who recently regained consciousness. The client is having difficulty communicating verbally with the team. Which of the following actions would be least appropriate?

• A. Begin client data collection before receiving the physician's order for the referral.
• B. Use documents to provide information for the referral.
• C. Wait for the physician's order for speech therapy before assisting with the appropriate documentation.
• D. Participate in the client referral process.

Correct answer: C

Rationale: In this scenario, the least appropriate action would be to wait for the physician's order for speech therapy before assisting with the appropriate documentation. The nurse should start by collecting client data without needing the physician's order, use documents to provide information for the referral, and actively participate in the client referral process. Waiting for the physician's order unnecessarily delays potentially crucial therapy for the client's recovery, affecting the timeliness and effectiveness of care. Therefore, choice C is the least appropriate as immediate action is required in such situations.

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