Nursing Elites

1. Gina, A client in prolong labor said she cannot go on anymore. The health care team decided that both the child and the mother cannot anymore endure the process. The baby is premature and has a little chance of surviving. Caesarian section is not possible because Gina already lost enough blood during labor and additional losses would tend to be fatal. The husband decided that Gina should survive and gave his consent to terminate the fetus. The principle that will be used by the health care team is:

• A. Beneficence
• B. Non malfeasance
• C. Justice
• D. Double effect

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

2. Each statement is true, except one. Which is the exception?

• A. Infant formulas should be discontinued at approximately 1 year of age
• B. Low-fat milk is not recommended for children younger than 2 years
• C. Special toddler formulas are available but are unnecessary
• D. Vitamin D-fortified whole milk should not be provided until 2 years

Correct answer: D

Rationale: The correct answer is D. Vitamin D-fortified whole milk should be provided starting at age 1 after discontinuing breast feeding or infant formulas, not at 2 years. Providing whole milk at age 2 is appropriate. Choices A, B, and C are correct statements: infant formulas are typically discontinued around 1 year of age, low-fat milk is not recommended for children under 2 years, and special toddler formulas are unnecessary.

3. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

4. Which type of bath would you recommend for a patient experiencing pruritus?

• A. Saline
• B. Colloidal (oatmeal)
• C. Water
• D. Sodium bicarbonate

Correct answer: B

Rationale: The best choice for a pruritus (itching) patient is a colloidal (oatmeal) bath, as it is known for its soothing effect on itchy, irritated skin. Saline, water, and sodium bicarbonate baths may not provide the same level of relief for pruritus. The nursing care should involve comprehensive assessments and appropriate interventions to optimize patient outcomes. In this case, a colloidal bath is the most suitable intervention for a patient experiencing pruritus.

5. A client who was normal weight before pregnancy asks about the recommended weight gain during pregnancy. What should the nurse advise?

• A. 18-40 pounds
• B. 25-35 pounds
• C. 11-20 pounds
• D. 15-25 pounds

Correct answer: B

Rationale: The correct answer is B: 25-35 pounds. According to standard prenatal guidelines, a client with a normal pre-pregnancy weight is recommended to gain between 25-35 pounds during pregnancy. This weight gain is important for the overall health of the mother and the developing baby. Choices A, C, and D are incorrect because they do not fall within the recommended weight gain range for a client with a normal pre-pregnancy weight.

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