Which direction given to the nursing assistant is most likely to accomplish the task of getting a urine specimen delivered to the lab immediately after collection?
- A. Make it a stat delivery.'
- B. Please do it as soon as you can after break.'
- C. This client is delirious, and we're worried about a urinary sepsis.'
- D. Take this client to the bathroom now and collect a urine specimen from this voiding. Take the specimen to the lab immediately.'
Correct Answer: D
Rationale: Effective delegation depends on clear, concise direction that leaves no room for question or interpretation. The specific instruction to collect and deliver immediately ensures the task is prioritized.
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An assessment of the skull of a normal 10-month-old baby should identify which of the following?
- A. closure of the posterior fontanel.
- B. closure of the anterior fontanel.
- C. overlap of cranial bones.
- D. ossification of the sutures.
Correct Answer: A
Rationale: The posterior fontanel should close by the age of 2 months.
In conducting a health screening for 12-month-old children, the nurse expects them to have been immunized against which of the following diseases?
- A. measles, polio, pertussis, hepatitis B
- B. diptheria, pertussis, polio, tetanus
- C. rubella, polio, pertussis, hepatitis A
- D. measles, mumps, rubella, polio
Correct Answer: B
Rationale: By 12 months, children should have received DTaP (diphtheria, tetanus, pertussis) and polio vaccines. MMR (measles, mumps, rubella) is given after 12 months, and hepatitis A is not routine at this age.
What is the best definition for ethics in nursing?
- A. advocating for the client
- B. knowing your scope of practice
- C. being able to differentiate right from wrong
- D. being willing to report violations
Correct Answer: C
Rationale: Ethics in nursing is being able to differentiate right from wrong.
When obtaining a health history on a menopausal woman, which information should a nurse recognize as a contraindication for hormone replacement therapy?
- A. family history of stroke
- B. ovaries removed before age 45
- C. frequent hot flashes and/or night sweats
- D. unexplained vaginal bleeding
Correct Answer: D
Rationale: Unexplained vaginal bleeding is a contraindication for hormone replacement therapy. Family history of stroke is not a contraindication for hormone replacement therapy. If the woman herself had a history of stroke or other blood-clotting events, hormone therapy could be contraindicated. Frequent hot flashes and/or night sweats can be relieved by hormone replacement therapy.
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.