Nursing Elites

1. Under what circumstances can an individual receive medical care without giving informed consent?

• A. when the durable power of attorney for health care is not available
• B. in an emergency, life-or-death situation
• C. when the physician is not available for discussion with the client
• D. when they (clients) are not able to speak for themselves

Correct answer: B

Rationale: An individual may receive medical care without giving informed consent in an emergency, life-or-death situation. This exception allows healthcare providers to provide immediate treatment to save a person's life or prevent serious harm when time is of the essence. Choices A, C, and D are incorrect because in all other situations, informed consent is required. The durable power of attorney for health care should be involved if available, the physician should have a discussion with the client in non-life-threatening situations, and in cases where clients are unable to speak for themselves, their designated representative or responsible party should be involved in the consent process.

2. The LPN has been given assignments by the RN. Which assignment should the LPN question as being beyond the scope of the LPN?

• A. The LPN is assigned to care for a client with diabetes mellitus who needs instructions reinforced on how to self-administer insulin.
• B. The LPN is assigned to reinforce discharge teaching about dressing changes and medications to a 35-year-old man.
• C. The LPN is assigned to care for a 75-year-old woman, hospitalized for dehydration, who is being discharged home today with no medications.
• D. The LPN is assigned to care for a woman with newly diagnosed leukemia who will be receiving her initial dose of chemotherapy.

Correct answer: D

Rationale: The LPN should be able to recognize when an assignment is beyond their scope of practice. Administering chemotherapy for leukemia is not within the scope of practice for the LPN, and this assignment should be questioned. Choices A, B, and C are within the scope of practice for an LPN. Reinforcing teaching on self-administration of insulin, assisting with discharge instructions on dressing changes, and caring for a client being discharged with no medications are all appropriate tasks for an LPN.

3. A nursing care plan for a client with sleep problems has been implemented. All of the following should be expected outcomes except:

• A. the client reports no episodes of awakening during the night.
• B. the client falls asleep within 1 hour of going to bed.
• C. the client reports satisfaction with their amount of sleep.
• D. the client rates sleep as an 8 or more on the visual analog scale.

Correct answer: B

Rationale: An expected outcome for a nursing care plan targeting sleep problems is that the client reports no episodes of awakening during the night, the client reports satisfaction with their amount of sleep, and the client rates sleep as an 8 or more on the visual analog scale. Falling asleep within 1 hour of going to bed is not necessarily an expected outcome. While it is generally desirable for individuals to fall asleep within a reasonable time frame, this specific timeframe may vary among individuals, and it is not a strict criterion for successful sleep outcomes. Therefore, the correct answer is that the client falls asleep within 1 hour of going to bed, as this is not a definitive measure of the effectiveness of the nursing care plan for sleep problems.

4. What is the correct instruction to give a client undergoing mammography?

• A. Do not use underarm deodorant.
• B. Wear comfortable clothing.
• C. Avoid caffeine prior to the procedure.
• D. Bring a list of current medications.

Correct answer: A

Rationale: The correct instruction for a client undergoing mammography is not to use underarm deodorant. Underarm deodorant can cause confusing shadows on the X-ray film, affecting the accuracy of the mammogram. Choices B, C, and D are incorrect. While wearing comfortable clothing is advisable, it is not the primary instruction for mammography. Avoiding caffeine and bringing a list of current medications are not specific instructions related to mammography preparation and are therefore not the correct answers.

5. The nurse is teaching a client about sleep and gives background information on normal sleep patterns. Which of the following substances promotes sleep?

• A. serotonin
• B. cortisol
• C. alcohol
• D. narcotics

Correct answer: A

Rationale: Serotonin is a substance found in the body that promotes sleep. It plays a role in the synthesis of a hypnogenic factor that directly induces sleep. Cortisol is a stress hormone that can disrupt sleep patterns. Alcohol can disrupt REM sleep and negatively impact sleep quality. Narcotics, like alcohol, can interfere with sleep architecture and lead to poor quality sleep. Therefore, the correct answer is serotonin as it is associated with promoting sleep, while the other substances listed can have negative effects on sleep patterns.

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