Nokea
The nurse is conducting intake interviews of children at a city clinic. Which child is most susceptible to contracting lead poisoning?
- A. An adolescent who works part-time in a paint factory
- B. A 2-year-old who plays on aging outdoor playground equipment
- C. A 10-year-old who has Type 1 diabetes mellitus
- D. An 8-year-old who lives in a housing project
Correct Answer: B
Rationale: Children playing on aging playground equipment are at higher risk of lead poisoning due to potential exposure from old paint. This is because deteriorating paint on older playground equipment may contain lead, which can be ingested by young children. Choices A, C, and D do not directly involve potential exposure to lead paint, making them less susceptible to lead poisoning compared to a child playing on aging playground equipment.
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A female client with borderline personality disorder is being discharged today. During morning rounds, the client complains about the aloofness of the night shift nurse and expresses joy to see the nurse on duty. Which response is best for the nurse to provide to this client's dichotomous tendency?
- A. I am glad you like me. Which nurse was acting aloof to you?
- B. Tomorrow I will talk to that nurse about how you were treated last night.
- C. What did the night nurse do that makes you think she is aloof?
- D. I am happy that you are getting better and will be able to go home.
Correct Answer: A
Rationale: Choice A is the best response as it acknowledges the client's feelings while exploring their concerns. By asking which nurse was acting aloof, the nurse shows understanding and allows the client to express their feelings further. This response validates the client's emotions and fosters a therapeutic relationship. Choice B focuses on a future action without addressing the immediate concern at hand. Choice C seeks clarification on the night nurse's behavior, which is a good approach but lacks the personal touch of Choice A. Choice D shifts the focus away from the client's current feelings and concerns, missing the opportunity to address the dichotomous thinking displayed by the client.
Which behavior is most likely to result in a breach of client confidentiality?
- A. Discussing a client's condition during a teaching conference for nursing staff caring for the client
- B. Two nurses planning a client's care while having lunch in the hospital cafeteria
- C. Nursing students on the same team discussing their assigned client's conditions
- D. A registered nurse privately sharing personal feelings about a client with another nurse on the team
Correct Answer: B
Rationale: The correct answer is B. Discussing client information in a public area, such as a cafeteria, may lead to breaches of confidentiality. Choice A involves discussing a client's condition in a professional setting, which is not likely to result in a breach as it is for educational purposes. Choice C involves nursing students discussing their assigned client's conditions, which is common in a learning environment and not necessarily a breach of confidentiality. Choice D involves a private conversation between healthcare professionals, which is less likely to result in a breach compared to discussing in a public area like a cafeteria where non-authorized individuals may overhear the conversation.
The parents of a 6-year-old child recently diagnosed with Duchenne muscular dystrophy tell the nurse that their child wants to continue attending swimming classes. How should the nurse respond?
- A. Encourage the parents to allow the child to continue attending swimming lessons with supervision
- B. Suggest that the child be encouraged to participate in a team sport to promote socialization
- C. Explain that their child is not mature enough to understand the risks associated with swimming
- D. Provide a list of alternative activities that are less likely to cause the child to experience fatigue
Correct Answer: A
Rationale: Encouraging the parents to allow the child to continue attending swimming lessons with supervision is the most appropriate response. Swimming can be beneficial for the child, providing both exercise and enjoyment. Supervision can help manage any risks associated with swimming. Choice B is incorrect because the child's preference for swimming should be respected, and swimming can still offer socialization opportunities. Choice C is incorrect as it undermines the child's capability to understand the situation. Choice D is less appropriate as it does not address the child's interest in swimming and may limit beneficial physical activity.
What explanation is best for the nurse to provide a client who asks the purpose of using the log-rolling technique for turning?
- A. Working together can decrease the risk of back injury.
- B. The technique is intended to maintain straight spinal alignment.
- C. Using two or three people increases client safety.
- D. Turning instead of pulling reduces the likelihood of skin damage.
Correct Answer: B
Rationale: The correct answer is B: 'The technique is intended to maintain straight spinal alignment.' Log-rolling is a technique used to move a person as a single unit to maintain the alignment of the spinal column. This is crucial to prevent spinal cord injury, especially in clients with suspected spine fractures. Choice A is incorrect because log-rolling focuses on spinal alignment, not just decreasing back injury risks. Choice C is incorrect because the number of people involved is not the primary purpose of log-rolling, which is maintaining spinal alignment. Choice D is incorrect because while turning instead of pulling may help prevent skin damage, the primary goal of log-rolling is to protect the spine, not the skin.
After completion of mandatory counseling, the impaired nurse has asked nursing administration to allow return to work. When the nurse administrator approaches the charge nurse with the impaired nurse's request, what action is best for the charge nurse to take?
- A. Ask to meet with the impaired nurse's therapist before allowing the nurse back on the unit
- B. Meet with staff to assess their feelings about the impaired nurse's return to the unit
- C. Since treatment is completed, assign the nurse to routine RN responsibilities
- D. Allow the impaired nurse to return to work and monitor medication administration
Correct Answer: D
Rationale: Allowing the impaired nurse to return to work with monitoring is the best course of action in this scenario. By monitoring the impaired nurse's medication administration, the charge nurse can ensure safe practice while supporting the nurse's reintegration into the work environment. Meeting with the therapist (Choice A) is not within the charge nurse's scope of responsibility and may violate the impaired nurse's privacy. Assessing staff feelings (Choice B) is important but should be done by leadership, not the charge nurse. Simply assigning routine duties (Choice C) may not address the need for monitoring and support required in this situation.