Nokea
A nurse is assessing a client who is postoperative following a left leg below-the-knee amputation. Which of the following client statements indicates the potential need for a referral to an occupational therapist?
- A. I hope I can adjust to using crutches while I am recovering.
- B. I am worried about taking care of my toddler at home.
- C. I just don't think I can handle looking at my leg.
- D. I am not sure how I will pay for all the therapy I will need.
Correct Answer: A
Rationale: The client's statement about adjusting to using crutches while recovering suggests a potential need for occupational therapy referral. Occupational therapists assist individuals in regaining independence in activities of daily living, including mobility aids and adaptations. Choices B, C, and D are more indicative of emotional or financial concerns and may require referrals to other healthcare professionals like counselors or financial advisors, rather than occupational therapists.
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When developing an educational program for staff regarding a new intravenous pump, what is the correct sequence of actions for a nurse to take?
- A. Develop learning objectives for the program
- B. Identify what skills to teach the staff members
- C. Conduct program evaluation with staff members
- D. Schedule several sessions of the program
Correct Answer: B
Rationale: The correct sequence of actions when developing an educational program for staff regarding a new intravenous pump is to first identify what skills to teach the staff members. This step is essential as it sets the foundation for the learning objectives to be developed next. Once the learning objectives are established, scheduling several sessions of the program can be planned accordingly. Finally, after the program has been conducted, program evaluation with staff members should take place to assess the effectiveness of the educational program. Therefore, options A, C, and D are out of sequence, making them incorrect choices.
A client with a tumor refuses surgery, but the client's partner wants it. Which is the deciding factor in determining if the surgery will be done?
- A. Whether the partner is the client's durable power of attorney for healthcare
- B. Whether the client understands the risk of refusing the procedure
- C. Whether the client's refusal is based on religious belief
- D. Whether the facility's ethical committee reaches a consensus on the case
Correct Answer: B
Rationale: The correct answer is B because the client's understanding of the risks involved in refusing the surgery is crucial in determining the course of action. In this scenario, the client's autonomy and decision-making capacity take precedence. Choice A is not directly relevant to the decision-making process regarding surgery. Choice C, religious beliefs, may influence the decision but should not be the determining factor in this case. Choice D involving the facility's ethical committee is not typically involved in individual patient care decisions.
A nurse on a med-surg unit is caring for a group of clients with the assistance of an LPN and an AP. Which of the following tasks should the nurse assign to the LPN?
- A. Reinforce dietary teaching with a client who has heart disease.
- B. Obtaining a urine specimen from an older adult client
- C. Providing postmortem care for a client who has just died.
- D. Accompanying a client who just had a wound debridement to PT.
Correct Answer: A
Rationale: The correct answer is to reinforce dietary teaching with a client who has heart disease. This task falls within the LPN's scope of practice as they can provide education and support related to nutrition. Obtaining a urine specimen (Choice B) is typically performed by nursing assistants. Providing postmortem care (Choice C) is a sensitive task usually performed by registered nurses. Accompanying a client to physical therapy (Choice D) is often done by nursing assistants or other supportive staff.
Serge, who has diabetes mellitus, is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of action for the nurse regarding Serge's oral medications?
- A. Administer the oral agents immediately after the test.
- B. Notify the diagnostic department and request orders.
- C. Notify the physician and request orders.
- D. Administer the oral agents with a sip of water before the test.
Correct Answer: C
Rationale: The best plan of action for the nurse is to notify the physician and request orders regarding Serge's oral medications. By involving the physician, the nurse ensures that appropriate instructions are obtained, considering Serge's medical condition and the need for NPO status for the diagnostic test. Administering the medications without medical guidance (choice A) can be risky, as it may affect the test results. Notifying the diagnostic department (choice B) is not the most direct and appropriate action; the physician is the primary healthcare provider responsible for medication orders. Administering the medications with water before the test (choice D) is not advisable when the patient is supposed to be NPO, as it can interfere with the test requirements.
Select the type of skeletal fracture that is correctly paired with its description.
- A. A complete fracture: The fractured bone penetrates through the skin to the skin surface.
- B. A pathological fracture: A fracture that results from some physical trauma.
- C. A greenstick fracture: This bends but does not fracture the bone.
- D. An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament
Correct Answer: D
Rationale: The correct answer is D. An avulsion fracture occurs when a part of the bone is pulled away by a tendon or ligament. Choice A is incorrect because it describes an open fracture where the bone penetrates the skin. Choice B is incorrect as a pathological fracture results from an underlying disease weakening the bone, not physical trauma. Choice C is incorrect as a greenstick fracture involves the bone bending but not completely breaking.