Nokea
A concern regarding maternal and infant mortality and morbidity is that:
- A. a segment of the population is not receiving prenatal care.
- B. families appear unconcerned about quality health care.
- C. the personnel shortage in the maternity field will increase.
- D. maternal-child health workers are not adequately prepared.
Correct Answer: A
Rationale: There is a concern that a segment of the population is not accessing prenatal care, affecting infant and maternal mortality and morbidity.
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Which of these is true regarding advance directives?
- A. They must be reviewed and re-signed every 10 years in order to remain valid.
- B. An advanced directive is legally valid in every state, no matter which state it was created in.
- C. A physician must determine when a client is unable to make medical decisions for himself.
- D. They cannot be honored by EMTs (emergency medical technicians) unless signed by a doctor.
Correct Answer: D
Rationale: If summoned, EMTs are legally obligated to provide emergency care to a client, regardless of advance directive status, unless the directive is signed by a doctor. If the client is brought to the hospital, physicians will evaluate the client and implement the advance directive, if necessary. Two physicians, not one, are needed to determine if a client is unable to make decisions for himself/herself. Advance directives do not expire and remain in effect until they are changed. Some states do not honor advance directives created in other states, so if a client moves, he/she should check with his/her new state policies on this topic.
While taking care of a client, the nurse thinks that physical therapy in the hospital might be beneficial to their condition. Which of the following is the ideal referral process? A.Transport the client to the physical therapy room for treatment. ,B.Provide the client's medical record to the physical therapist. ,C.Contact the client's primary care provider to suggest a physical therapy referral.
- A. A) A, C, B
- B. B) A, B, C
- C. C) C, A, B
- D. D) C, B, A
Correct Answer: D
Rationale: For the client's referral to physical therapy, the nurse should first contact the primary care provider to discuss. Once the primary care provider provides the official referral, the physical therapist should have an opportunity to review the client's condition and medical record. Once the physical therapist has completed their review and is ready to see the client, the nurse can transport the client to physical therapy.
Carrying a donor card for organ donation means that:
- A. medical care is altered in the event of serious injuries to get organs for donation.
- B. the family or legally responsible party of a client has no decision-making authority in the event that the client is considered for organ donation.
- C. a client is allowed to revoke his decision for organ donation at any time.
- D. a client is considered an organ donor for only one organ or tissue.
Correct Answer: C
Rationale: Revocation of the decision for organ donation may occur at any time, by either the client or his responsible party. When organ donation is considered, as many organs as the donor wished to donate are considered and accepted for donation if found appropriate. Medical care for an individual during immediate care and/or resuscitation is not altered to declare a client dead and ready for organ donation.
An Rh-negative woman with previous sensitization has delivered an Rh-positive fetus. Which of the following nursing actions should be included in the client's care plan?
- A. emotional support to help the family deal with feelings of guilt about the infant's condition
- B. administration of MICRhoGam to the woman within 72 hours of delivery
- C. administration of Rh-immune globulin to the newborn within 1 hour of delivery
- D. lab analysis of maternal Direct Coombs' test
Correct Answer: A
Rationale: Sensitization means the mother has antibodies against Rh-positive blood, risking hemolytic disease in the fetus. Emotional support is critical to address guilt and concerns about the infant's condition.
An LPN works on an adult medical/surgical unit and has been pulled to work on the burn unit, which cares for clients of all ages. What should he do?
- A. He should take the assignment, but make it clear he will only care for adult clients.
- B. He should take the assignment, but explain the situation to the charge nurse and ask for a quick orientation before starting.
- C. He should refuse to take the assignment, as caring for infant and child population is not within his scope of practice.
- D. He should take the assignment, but ask to be paired with a more experienced LPN.
Correct Answer: B
Rationale: While the LPN may specialize in a certain type of nursing or feel more comfortable caring for a specific client population, he should be able to use his skill set to safely and independently care for other populations as well. However, the LPN should let the charge nurse know his background before beginning his shift so he can familiarize himself with new equipment, ask questions, and identify resources.