Nokea
Signs of internal bleeding include all of the following except:
- A. painful or swollen extremities
- B. a tender, rigid abdomen
- C. vomiting bile
- D. bruising
Correct Answer: C
Rationale: Vomiting bile is not typically a sign of internal bleeding but is more commonly associated with issues in the gastrointestinal tract. Signs of internal bleeding include painful or swollen extremities, a tender, rigid abdomen, and bruising. Painful or swollen extremities can indicate bleeding from an extremity injury, a tender, rigid abdomen can signal abdominal bleeding, and bruising can result from blood vessel damage. Therefore, the correct answer is 'C: vomiting bile,' as it is not a typical sign of internal bleeding.
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When a 17-year-old client arrives at the clinic suspecting a sexually transmitted infection, what information does the nurse provide concerning informed consent?
- A. She will need to sign an informed consent form.
- B. Her mother or father will need to be contacted for permission to treat her.
- C. A consent form is not needed if the problem is a sexually transmitted infection.
- D. Anyone over the age of 18 years may sign a consent form for her treatment.
Correct Answer: A
Rationale: Informed consent is a person's agreement to allow something, such as a treatment, to be performed. A consent form is required even if the problem is a sexually transmitted infection. If the client is a minor, the minor may sign the informed consent form in specific situations, including seeking treatment for a sexually transmitted infection. In this case, the 17-year-old client is seeking examination and treatment for a sexually transmitted infection, so she will need to sign the informed consent form. Contacting her parents for permission is not required in this situation. Choice C is incorrect because a consent form is necessary regardless of the medical issue. Choice D is incorrect because the individual's age is not the determining factor; rather, it is the nature of the medical service being sought that dictates the need for informed consent.
A risk management program within a hospital is responsible for all of the following except:
- A. identifying risks.
- B. controlling financial loss due to malpractice claims.
- C. ensuring that staff follow their job descriptions.
- D. analyzing risks and trends to guide further interventions or programs.
Correct Answer: C
Rationale: A risk management program within a hospital is responsible for identifying risks, controlling financial loss due to malpractice claims, and analyzing risks and trends to guide further interventions or programs. It is not responsible for ensuring that staff follow their job descriptions. Monitoring staff adherence to their job descriptions falls under the purview of departmental managers or supervisors. The primary focus of a risk management program is to assess, mitigate, and manage risks related to patient safety, quality of care, and financial implications, rather than overseeing staff job descriptions.
Under what circumstances is the legal right to confidentiality of client information waived?
- A. When a court system subpoenas information.
- B. When a family member requests health care information of a client.
- C. When a living will takes effect.
- D. When the client is declared incompetent by the legal system.
Correct Answer: A
Rationale: The legal right to confidentiality of client information is waived when a court system subpoenas information. This occurs when information is required for legal proceedings to occur, such as through summonses, court orders, or litigation information necessary for the court. Subpoenas are legal orders that compel the disclosure of information. The other choices do not inherently waive the legal right to confidentiality. A family member's request for health care information would typically require the client's consent or fall under specific legal exceptions. A living will dictates end-of-life care preferences but does not necessarily waive confidentiality. Lastly, the declaration of incompetence may impact decision-making capacity but does not automatically waive confidentiality.
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.
A licensed practical nurse (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 the LPN do?
- A. The LPN should take the assignment, but make it clear they will only care for adult clients.
- B. The LPN should take the assignment, but explain the situation to the charge nurse and ask for a quick orientation before starting.
- C. The LPN should refuse to take the assignment, as caring for the infant and child population is not within their scope of practice.
- D. The LPN should take the assignment, but ask to be paired with a more experienced LPN.
Correct Answer: B
Rationale: In this scenario, it is crucial for the LPN to demonstrate flexibility and a willingness to adapt to the new assignment that involves caring for clients of all ages. While the LPN may have expertise in a specific nursing area, it is essential to be able to provide care to diverse client populations. Accepting the assignment reflects a commitment to teamwork and patient care. However, to ensure safe and competent care, the LPN should communicate with the charge nurse about the situation. Requesting a quick orientation will help the LPN familiarize themselves with the burn unit's specific requirements, equipment, and protocols. This proactive approach allows the LPN to address any concerns, ask questions, and seek necessary support, ultimately ensuring the best care for all clients in the burn unit.
Choice A is incorrect because limiting care to only adult clients may not be feasible in a unit that cares for clients of all ages. Choice C is incorrect as refusing the assignment outright may not be the best approach without considering alternatives. Choice D is not the most effective option as asking to be paired with a more experienced LPN does not address the need for a quick orientation to the new unit.