Nokea
The nurse acts as an advocate for the nursing profession by performing all of the following activities except:
- A. encouraging political involvement by nurses with their legislators.
- B. acting as a first-aid provider for a children's athletic team.
- C. precepting newly licensed nurses in the work situation.
- D. encouraging as many persons to become nurses as possible.
Correct Answer: D
Rationale: The nurse acts as an advocate for the nursing profession by encouraging appropriate persons to become nurses, by being a positive role model and mentor, and by communicating the needs of nurses in the most professional manner possible, to those making the laws.
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The nursing staff has a normal nurse-to-client ratio of three clients per nurse on the floor. Nurse Ann tells nurse Christine that one of her client's status is declining but that she will do her best to juggle her other two clients. Which action is most appropriate?
- A. Nurse Christine should offer to give medications to nurse Ann's other two clients.
- B. Nurse Christine should inform their supervisor that assignments may need to be changed.
- C. Nurse Christine should ask the other nurses who might be able to help nurse Ann.
- D. Nurse Ann should try not to burden the other nurses and continue caring for her assigned clients.
Correct Answer: B
Rationale: When there is a change in the client's status, the supervisor should be made aware so that client care assignments can be changed as needed.
All of the following tasks could be delegated to a nursing assistant or unlicensed assistive personnel (UAP) except:
- A. monitoring intravenous infusion.
- B. assisting a client to the bathroom.
- C. offering fluid intake every 1-2 hours.
- D. monitoring/recording the amount of fluid taken.
Correct Answer: A
Rationale: Monitoring an intravenous infusion must be performed by an RN or LPN. Assisting during activity, offering fluids and recording intake are in the job scope of the nursing assistant.
The acts enacted by states to provide immunity from liability to persons who provide emergency care at an accident scene are called:
- A. Good Samaritan laws.
- B. HIPAA.
- C. Patient Self-Determination Act (PSDA).
- D. OBRA.
Correct Answer: A
Rationale: The Good Samaritan laws protect providers of care in an emergency situation. HIPAA's focus is confidentiality of information and right to privacy. The PSDA concerns a client's autonomous decision-making. OBRA was passed in the late 1980s to promote nursing home reform due to quality issues.
The nurse is teaching parents of a newborn about feeding their infant. Which of the following instructions should the nurse include?
- A. Use the defrost setting on microwave ovens to warm bottles.
- B. When refrigerating formula, don't feed the baby partially used bottles after 24 hours.
- C. When using formula concentrate, mix two parts water and one part concentrate.
- D. If a portion of one bottle is left for the next feeding, go ahead and add new formula to fill it.
Correct Answer: A
Rationale: Parents must be careful when warming bottles in a microwave oven because the milk can become superheated. When a microwave oven is used, the defrost setting should be chosen, and the temperature of the formula should be checked before giving it to the baby. Refrigerated, partially used bottles should be discarded after 4 hours because the baby might have introduced some pathogens into the formula. Returning the bottle to the refrigerator does not destroy pathogens. Formula concentrate and water are usually mixed in a 1:1 ratio of one part concentrate and one part water. Infants should be offered fresh formula at each feeding. Partially used bottles should not have fresh formula added to them. Pathogens can grow in partially used bottles of formula and be transferred to the new formula.
The nurse is caring for a client who has just tested positive for HIV. The client asks the nurse not to tell anyone outside of the care team about his diagnosis. What response is most appropriate?
- A. I have to inform all clients on the unit of your diagnosis as it is transmissible.'
- B. I will not communicate your diagnosis to anyone without your permission.'
- C. Because this is a communicable disease, it may need to be reported to the CDC.'
- D. You should not be concerned with who I share your diagnosis with.'
Correct Answer: C
Rationale: Many communicable diseases, such as HIV, have surveillance programs that require mandatory reporting.