Nursing Elites

1. Which of the following is an example of a living will?

• A. A client's son has been appointed to make his healthcare decisions if he becomes incapacitated
• B. A client has designated which of his children will receive his home and property before he dies
• C. A client has instructions that he does not want to be resuscitated through chest compressions if his heart stops beating
• D. A client designates what type of burial or cremation services he would want after his death

Correct answer: C

Rationale: A living will is a type of advanced directive that a client develops to stipulate his preferences for healthcare in the event that he is unable to do so. This includes specific instructions about medical treatments in certain situations. Choice C is the correct answer as it reflects a scenario where the client has clearly outlined their preference regarding resuscitation through chest compressions. Choices A, B, and D do not pertain to a living will. Choice A involves a healthcare proxy or agent, choice B involves a will or estate planning, and choice D involves funeral or burial arrangements, which are not part of a living will.

2. A 39-year-old woman presents for treatment of excessive vaginal bleeding after giving birth to twins one week ago. Which nursing diagnosis is most appropriate in this situation?

• A. Knowledge Deficit related to post-partum blood loss
• B. Self-Care Deficit related to post-partum neglect
• C. Fluid Volume Deficit related to post-partum hemorrhage
• D. Body Image Disturbance related to body changes after delivery

Correct answer: C

Rationale: The correct nursing diagnosis in this situation is 'Fluid Volume Deficit related to post-partum hemorrhage.' Post-partum hemorrhage can lead to excessive bleeding, putting the client at risk of fluid volume deficit due to the loss of blood volume. This diagnosis is most appropriate as it addresses the immediate concern of fluid loss. 'Knowledge Deficit related to post-partum blood loss' (Choice A) is incorrect as the priority in this case is addressing the physical issue of fluid volume deficit rather than knowledge deficit. 'Self-Care Deficit related to post-partum neglect' (Choice B) is not relevant to the situation described. 'Body Image Disturbance related to body changes after delivery' (Choice D) is not the most appropriate nursing diagnosis in this context where the primary concern is fluid volume deficit due to post-partum hemorrhage.

3. An infant is brought to the clinic by his mother, who has noticed that he holds his head in an unusual position and always faces to one side. Which of the following is the most likely explanation?

• A. Torticollis, with shortening of the sternocleidomastoid muscle
• B. Craniosynostosis, with premature closure of the cranial sutures
• C. Plagiocephaly, with flattening of one side of the head
• D. Hydrocephalus, with increased head size

Correct answer: A

Rationale: The correct answer is torticollis, characterized by the shortening of the sternocleidomastoid muscle, limiting the range of motion of the neck and causing the chin to point to the opposing side. Craniosynostosis is the premature closure of cranial sutures, leading to an abnormal head shape but not necessarily affecting head position. Plagiocephaly is flattening of one side of the head due to external forces or positioning, not muscle shortening. Hydrocephalus presents with an increased head size due to the accumulation of cerebrospinal fluid, not with a fixed head position.

4. Which of the following is an example of intragroup conflict?

• A. A nurse writes a grant for a non-profit organization to raise money for advertising
• B. Members of a multidisciplinary team cannot agree on the best course of action for a client
• C. A client does not receive his medication on time because the nurse was on break
• D. A nurse feels frustrated that her employer does not provide on-site child care

Correct answer: B

Rationale: Intragroup conflict refers to disagreements within a group. The correct answer, 'Members of a multidisciplinary team cannot agree on the best course of action for a client,' exemplifies this type of conflict well. In this scenario, professionals within the same team are unable to reach a consensus on how to proceed with client care. Choices A, C, and D do not reflect intragroup conflict. Writing a grant for a non-profit organization, a client not receiving medication due to a nurse's break, and a nurse feeling frustrated about the lack of on-site child care do not involve conflicts within a group of professionals.

5. A client has volunteered to take part in a research study. After participating for two months, he decides that he can no longer tolerate the study and decides to leave. What are the client's rights in this situation?

• A. The client has a right to be released from the study but must reimburse the researchers for charges incurred
• B. The client has a right to be released from the study without any liability
• C. The client has a right to be released from the study but is prohibited from participating in any future studies
• D. The client does not have the right to be released from the study; he must finish his participation

Correct answer: B

Rationale: When a client voluntarily participates in a research study and later decides to withdraw, they have the right to be released from the study without any liability. It is unethical to force a participant to continue in a study against their will as this violates their autonomy and personal rights. Choice A is incorrect as it suggests that the client must reimburse the researchers for charges incurred, which is not typically the case unless agreed upon beforehand. Choice C is incorrect as there is no standard practice prohibiting a participant from future studies just because they withdrew from a current one. Choice D is incorrect because participants always have the right to withdraw from a research study at any time.

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