Nursing Elites

1. 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.

2. What is a true statement about post-discharge follow-up?

• A. The nurse should ensure the client is educated on their discharge instructions.
• B. If the client seems stable, they likely do not need a follow-up visit.
• C. The physician is responsible for ensuring the client has their prescriptions upon discharge.
• D. If the client has questions, the nurse should address them before discharge.

Correct answer: A

Rationale: The correct statement is that the nurse should ensure the client is educated on their discharge instructions. This is crucial to promote continuity of care and prevent adverse events. The responsibility of educating the client falls on the nurse, not assuming stability without a follow-up visit. While the physician may prescribe medications, it is the nurse's responsibility to ensure the client has them before discharge. Instructing the client to bring up questions at a follow-up appointment is not ideal; all questions should be addressed before discharge to ensure the client's understanding and compliance.

3. A client scheduled for surgery tells the nurse that he signed an informed consent for the surgical procedure but was never told about the risks of the surgery. The nurse serves as the client's advocate by undertaking which action?

• A. Reassuring the client that the risks are minimal
• B. Noting in the client's record that the client was not told about the risks of the surgery
• C. Writing a note on the front of the client's record so that the surgeon will see it when the client arrives in the operating room
• D. Informing the surgeon verbally about the lack of information provided to the client

Correct answer: B

Rationale: A nurse serves as a client advocate by protecting the client's right to be informed and to participate in decisions regarding care. In this scenario, the nurse should document in the client's record that the client was not informed about the risks of the surgery. This action ensures that the issue is officially noted and can be addressed by the healthcare team. Reassuring the client that the risks are minimal is incorrect because it dismisses the client's concerns and does not address the lack of information provided. Writing a note on the client's chart to inform the surgeon is not as effective as ensuring that the issue is officially documented in the client's record, where it can be reviewed and addressed by the healthcare team. Informing the surgeon verbally is not as reliable as documenting the concern in the client's record, which provides a formal and lasting record for review and follow-up.

4. In what order should the LPN see the following clients? Use appropriate letters to match the correct order

• A. A, D, B, C
• B. C, B, D, A
• C. D, C, B, A
• D. B, C, A, D

Correct answer: B

Rationale: The correct order for the LPN to see the clients is C, B, D, A. It is crucial to prioritize client care based on the urgency of their conditions. The 53-year-old client with lower leg swelling complaining of sudden onset headache and blurry vision (Client C) should be seen first as they are at the highest risk for serious healthcare complications. Next, the LPN should attend to the 23-year-old client with a left arm fracture after an MVA complaining of significant pain in his arm (Client B). Following that, the LPN can address the 47-year-old client requesting more information regarding her surgery scheduled in three hours (Client D). Lastly, the LPN should attend to the 72-year-old client with pneumonia asking to order her dinner (Client A). This order ensures that the most critical needs are met first, followed by the less urgent ones. Choice A is incorrect as it places the 72-year-old client before the 23-year-old client with a painful arm. Choice B is incorrect as it prioritizes the 53-year-old client last. Choice D is incorrect as it does not address the urgency of the clients' conditions appropriately.

5. A nurse provides instructions to a mother about crib safety for her infant. Which statement by the mother indicates a need for further instructions?

• A. ''Wood surfaces on the crib need to be free of splinters and cracks.''
• B. ''I need to keep large toys out of the crib.''
• C. ''The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body.''
• D. ''The drop side needs to be impossible for my infant to release.''

Correct answer: C

Rationale: The correct answer is, ''The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body.'' This statement indicates a need for further instructions as the distance between the slats should be no more than 2? inches to prevent entrapment of the infant's head and body, not 4 inches. Allowing a larger gap can pose a risk of entrapment or injury to the infant. Keeping large toys out of the crib is essential to prevent the infant from using them to climb out, which could result in serious injuries. Ensuring the drop side of the crib is impossible for the infant to release is crucial to prevent falls and injuries. Additionally, maintaining wood surfaces on the crib free of splinters, cracks, and lead-based paint is vital for the infant's safety and well-being.

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