Nursing Elites

1. The ICU nurse caring for a client who has just been declared brain dead can expect to find evidence of the client's wishes regarding organ donation:

• A. on the client's driver's license.
• B. in the client's safety deposit box.
• C. in the client's last will and testament.
• D. on the client's insurance card.

Correct answer: A

Rationale: In most states, indication of organ donor status is found on the client's driver's license, making it easily accessible for decision-making in critical situations like declaring brain death. Evidence in a last will and testament or a safety deposit box may not be promptly available. Information about organ donation is typically not included on insurance cards. The primary care physician's health record documentation could also be a relevant source for the ICU nurse. Therefore, the correct answer is finding evidence of the client's wishes regarding organ donation on the client's driver's license.

2. Which medication might the healthcare provider prescribe if the client expresses discomfort with being in the enclosed space of a CT scanner?

• A. Valium (diazepam)
• B. Clozaril (clozapine)
• C. Catapres (clonidine)
• D. Lasix (furosemide)

Correct answer: A

Rationale: Valium (diazepam) is a sedative that might be prescribed to help a client who feels uncomfortable in the confined space of a CT scanner. Diazepam can help reduce anxiety and promote relaxation, making the scanning process more tolerable. Clozaril (clozapine), Catapres (clonidine), and Lasix (furosemide) are not sedatives and wouldn't be appropriate for alleviating discomfort related to being in an enclosed space. Clozaril is an antipsychotic used to treat schizophrenia, Catapres is a blood pressure medication, and Lasix is a diuretic used to treat fluid retention, so they are not indicated for this situation.

3. A nurse is supervising a new nursing graduate in various procedures. Which action by the new nursing graduate constitutes a negligent act?

• A. Giving a verbal report to the nurse on the oncoming shift
• B. Checking neurological signs in a client with a head injury
• C. Contacting a healthcare provider about a change in a client's blood pressure
• D. Using clean gloves to change a gastrostomy tube dressing

Correct answer: D

Rationale: Negligent acts in nursing include various errors that can harm the client, such as medication errors, intravenous therapy errors, burns, falls, failure to use aseptic technique, failure to provide adequate monitoring, and failure to report significant changes in a client's condition. In this scenario, using clean gloves to change a gastrostomy tube dressing is a negligent act because sterile gloves should be used when changing a dressing over broken skin. Choices A, B, and C are not negligent acts as they involve appropriate nursing actions: giving a verbal report, checking neurological signs, and contacting a healthcare provider about a change in a client's blood pressure.

4. The LPN needs to delegate a task to the nurse aide who is new to the unit. Which of these is the best option for the nurse to choose in proceeding?

• A. Delegate the task to the nurse aide, confirm understanding, and follow up to ensure the task was safely and correctly done.
• B. Delegate the task to the nurse aide, watch them perform the task without them seeing you, and follow up to ensure the task was done safely and accurately.
• C. Delegate the task to the nurse aide, supervise if needed, and check in after the task to see if help is needed.
• D. Delegate the task to the nurse aide, ensure understanding of the task, and supervise the task being performed.

Correct answer: B

Rationale: Delegation is transferring responsibility for a task but sharing its accountability. It is the delegator's responsibility to ensure that the delegatee understands the task before it is performed and to follow up afterward to ensure it was completed correctly and safely. Option B is the best choice because it allows the nurse to observe the nurse aide performing the task without pressure, which can provide insights into the aide's abilities and understanding. This method also allows for immediate feedback and correction if needed. Choice A is incorrect because confirming understanding alone may not provide a complete picture of the aide's competence in performing the task. Choice C is incorrect as it suggests supervising only if needed, which may not provide adequate oversight for a new nurse aide. Choice D is incorrect because supervising the task being performed does not allow for an objective assessment of the aide's abilities and understanding.

5. The nurse should teach parents of small children that the most common type of first-degree burn is:

• A. scalding from hot bath water or spills
• B. contact with hot surfaces such as stoves and fireplaces
• C. contact with flammable liquids or gases resulting in flash burns
• D. sunburn from lack of protection and overexposure

Correct answer: D

Rationale: The most common type of first-degree burn in small children is sunburn, often due to lack of protection and overexposure to the sun. This type of burn highlights the importance of educating parents about using sunscreens and ensuring children are adequately protected from the sun's harmful rays. Choices A, B, and C describe scenarios that can lead to burns but are not the most common type of first-degree burn in small children, making them incorrect.

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