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When the physician telephones to order a therapy such as a medication for the client of a student nurse, who is the best person to take this telephone order?
- A. whoever is authorized by hospital policy
- B. the student nurse giving the client's care
- C. the student nurse's instructor
- D. any licensed nurse on duty
Correct Answer: A
Rationale: Hospital policy dictates who takes telephone orders, ensuring legal and safety compliance, typically a licensed nurse, not a student or instructor alone. This standard protects clients from errors by untrained personnel, aligning with nursing scope and institutional rules for accurate order execution.
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A client with pneumonia exhibits signs of respiratory distress and decreased oxygen saturation. What is the primary indication for initiating oxygen therapy in this client?
- A. Promoting lung expansion
- B. Enhancing antimicrobial therapy
- C. Improving oxygen delivery to tissues
- D. Reducing the risk of bacterial resistance
Correct Answer: C
Rationale: Improving oxygen delivery to tissues (C) is the primary indication for oxygen therapy in pneumonia with distress and low SpO2, correcting hypoxia from impaired gas exchange. Lung expansion (A) is secondary. Antimicrobial therapy (B) treats infection, not oxygenation. Bacterial resistance (D) is unrelated. Enhanced oxygen delivery supports vital organs, per infectious disease care principles, critical in acute respiratory compromise.
The government passed a law improving health access. This is an example of?
- A. Health policy
- B. Care coordination
- C. Patient-centered care
- D. Health literacy
Correct Answer: A
Rationale: Law improving access is health policy (A) rules for care, per definition. Coordination (B) organizes, patient-centered (C) tailors, literacy (D) understands not law-specific. A fits policy impact, making it correct.
All of the following are purpose of inflammation except
- A. Increase heat, thereby produce abatement of phagocytosis
- B. Localized tissue injury by increasing capillary permeability
- C. Protect the issue from injury by producing pain
- D. Prepare for tissue repair
Correct Answer: A
Rationale: Inflammation aims to protect and heal tissue, not hinder it. Increasing heat (A) enhances phagocytosis by boosting immune cell activity, not abating it, making this statement incorrect and the exception. Localized injury response (B) occurs as capillary permeability increases, delivering immune cells to the site. Pain (C) protects by discouraging movement, aiding healing. Preparing for tissue repair (D) is a key goal as inflammation clears debris and initiates recovery. The misstatement in A reverses the biological role of heat, which supports immune function rather than suppressing it, confirming A as the answer since it does not align with inflammation's purposes.
Which of the following statement best describe advocacy in nursing?
- A. Ignoring patient needs
- B. Supporting patient rights
- C. A routine task
- D. A medical order
Correct Answer: B
Rationale: Advocacy is supporting patient rights (B), per nursing e.g., voicing wishes. Not ignoring (A), not routine (C), not order (D) rights-focused. B best defines advocacy's protective role, like for Mr. Gary's choices, making it correct.
What do you think is the most important nursing order in a client with major head trauma who is about to receive bolus enteral feeding?
- A. Measure intake and output
- B. Check albumin level
- C. Monitor glucose levels
- D. Increase enteral feeding
Correct Answer: A
Rationale: Monitoring I&O ensures fluid balance with hyperosmotic enteral feeding.