Nursing Elites

1. What are major competencies for the nurse giving end-of-life care?

• A. demonstrating respect and compassion, and applying knowledge and skills in the care of the family and the client.
• B. assessing and intervening to support total management of the family and client.
• C. setting goals, expectations, and dynamic changes to care for the client.
• D. keeping all sad news away from the family and client.

Correct answer: A

Rationale: Major competencies for nurses providing end-of-life care involve a combination of skills and qualities. Demonstrating respect and compassion towards the family and the client is essential in end-of-life care. Additionally, applying knowledge and skills in caring for both the family and the client is crucial to ensure comprehensive and compassionate care. Option A is the correct choice as it accurately reflects these key competencies. Option B, which focuses on assessing and intervening for total management, is important but does not fully address the holistic approach necessary for end-of-life care. Option C, about setting goals and expectations, is relevant but not as critical as the core competencies mentioned in option A. Option D is incorrect as withholding sad news goes against the principles of honesty and transparency in end-of-life care.

2. A nurse is conducting a psychosocial assessment of a young adult. Which observations would lead the nurse to determine that the client is demonstrating a sign of emotional health?

• A. The young adult is sensitive to criticism.
• B. The young adult verbalizes unrealistic fears.
• C. The young adult verbalizes disappointment with life.
• D. The young adult verbalizes satisfaction with friendships.

Correct answer: D

Rationale: The correct answer is that the young adult verbalizes satisfaction with friendships. Emotional health in young adults is characterized by various positive signs, including satisfaction with social interactions and friendships. Expressing contentment with friendships indicates a healthy emotional state, fostering positive social connections. On the other hand, sensitivity to criticism, verbalizing unrealistic fears, and expressing disappointment with life are all indicative of emotional distress and potential mental health challenges. These behaviors can hinder social relationships and overall emotional well-being.

3. A multigravida pregnant woman asks the nurse when she will start to feel fetal movements. Around which week of gestation does the nurse tell the mother that fetal movements are first noticed?

• A. 16 weeks
• B. 6 weeks
• C. 8 weeks
• D. 12 weeks

Correct answer: A

Rationale: Fetal movements (quickening) are first noticed by multigravida pregnant women at 16 to 20 weeks of gestation and gradually increase in frequency and strength. This is when the mother typically begins to feel the baby's movements. Choices B, C, and D are incorrect because fetal movements are not felt as early as 6, 8, or 12 weeks of gestation. At 6 weeks, the embryo's movements are not yet strong enough to be felt by the mother. By 8 weeks, the movements are still too subtle to be perceived. At 12 weeks, although fetal movements start, they are usually not strong enough to be felt by the mother.

4. The LPN is taking care of a client who is on Phenelzine (Nardil) for depression. Which meal would the nurse encourage the client to avoid?

• A. steak and potatoes
• B. prosciutto and cheese plate
• C. orange juice and toast
• D. carbonated water, shrimp and rice

Correct answer: B

Rationale: The correct answer is 'prosciutto and cheese plate.' Phenelzine (Nardil) is an MAOI (Monoamine Oxidase Inhibitor), and clients on these drugs should avoid foods high in tyramine due to the risk of dangerous elevations in blood pressure. Prosciutto and aged cheeses are examples of foods rich in tyramine, so they should be avoided. Choices A, C, and D do not contain high levels of tyramine and are considered safe to consume while on Phenelzine.

5. During a genital examination of a male client, a nurse notices wrinkled skin on the penis and scrotum. What should the nurse do based on this finding?

• A. Documents the normal finding
• B. Checks for penile discharge, as this indicates infection
• C. Palpates for a mass in the scrotum, as wrinkling suggests the presence of one
• D. Obtains additional subjective data from the client, focusing on the scrotal abnormality

Correct answer: A

Rationale: The penile skin typically appears wrinkled and hairless, without lesions, during a normal examination. Also, the scrotal skin naturally has a wrinkled appearance known as rugae. It is common for the left half of the scrotum to be positioned lower than the right, indicating normal asymmetry. Given these normal variations, the nurse should document the finding of wrinkled skin on the penis and scrotum. Checking for penile discharge or palpating for a mass in the scrotum is not indicated based on the presence of wrinkled skin, as this is a normal finding. Obtaining additional subjective data focusing on a scrotal abnormality is unnecessary since the wrinkled appearance is typical.

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