Nokea
Which of the following activities is not part of client advocacy?
- A. involving the client in treatment and decision-making
- B. standing up for what is right for the client
- C. sharing your personal opinions to help provide additional information
- D. encouraging the client to advocate for themselves
Correct Answer: C
Rationale: The correct answer is 'sharing your personal opinions to help provide additional information.' Client advocacy involves supporting the client's autonomy and choices. It is essential for the nurse to involve the client in treatment and decision-making (Choice A) to ensure their preferences are considered. Standing up for what is right for the client (Choice B) is also a crucial aspect of advocacy, ensuring their rights and well-being are protected. Encouraging the client to advocate for themselves (Choice D) empowers the client to express their needs. However, sharing personal opinions (Choice C) may influence the client's decision-making process and is not a recommended practice in client advocacy, as it can compromise the client's autonomy.
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The nurse receives an assignment of three clients. Which of the following should the nurse consider as the highest priority when determining which client to assess first?
- A. the client who most recently rang their call bell
- B. the client who has been waiting the longest for their call bell to be answered
- C. the client who is in the most pain
- D. the client who may have a risk for an airway obstruction
Correct Answer: D
Rationale: The nurse should prioritize assessing a client with a potential airway obstruction first based on the ABCs (airway, breathing, circulation) principle. Maintaining a clear airway is crucial for oxygenation and ventilation, making it the highest priority. Choices A and B focus on call bells and waiting times, which are important but not life-threatening in comparison to airway concerns. While pain management is essential, it takes precedence after addressing immediate life-threatening issues like airway compromise.
Which of these statements is true regarding advance directives?
- A. They must be reviewed and re-signed every 10 years in order to remain valid.
- B. An advance directive is legally valid in every state, regardless of the state it was created in.
- C. A physician must determine when a client is unable to make medical decisions for themselves.
- D. They cannot be honored by EMTs (emergency medical technicians) unless signed by a doctor.
Correct Answer: D
Rationale: The correct statement is that advance directives cannot be honored by EMTs unless they are signed by a doctor. EMTs are required to provide emergency care to a client, irrespective of their advance directive status, unless the directive has been signed by a doctor. When a client is brought to the hospital, physicians will assess the client and implement the advance directive if necessary. Advance directives do not need to be reviewed and re-signed every 10 years to remain valid; they remain in effect until changed. While advance directives are legally valid in most states, some states may not honor those created in other states, so it's advisable to check the new state's policies if a client moves. Additionally, it typically requires two physicians, not just one, to determine if a client is unable to make medical decisions for themselves.
An LPN is having a conflict with another nurse during her shift. She has tried to discuss the issues with the nurse with no resolution. What is the most appropriate way for the LPN to proceed?
- A. Report the conflict to the director of nursing over the unit.
- B. Report the conflict to the assigned charge nurse of the unit.
- C. Report the conflict to the nurse manager of the unit.
- D. Discuss the conflict with the other nurse to attempt resolution of the issue.
Correct Answer: B
Rationale: In this scenario, the most appropriate way for the LPN to proceed is to report the conflict to the assigned charge nurse of the unit. Following the chain of command is crucial in a professional setting to address conflicts effectively. Reporting the issue to the charge nurse, who is the immediate supervisor, allows for a structured approach to resolving the conflict. Reporting directly to higher levels such as the director of nursing or nurse manager may bypass the appropriate hierarchy and could create unnecessary tension. Attempting to resolve the issue independently with the other nurse may not be effective if previous attempts have failed, making it essential to involve the immediate supervisor.
While documenting on a paper form, the nurse realizes they have made a mistake writing the progress note. What should the nurse do?
- A. Use a black marker to fully cover up the mistake.
- B. Do not make any changes to the progress note but explain later in the note that a mistake was made and note what should have been written.
- C. Use whiteout to cover over the mistake and write over it.
- D. Inform the client about the mistake and offer to provide a corrected copy.
Correct Answer: B
Rationale: In the scenario described, it is essential for the nurse not to alter the original progress note. Option B is the correct course of action as it maintains the integrity of the documentation while acknowledging the error for transparency and accuracy. Using a black marker (Option A) or whiteout (Option C) can be seen as an attempt to conceal the mistake, which is not in line with professional standards. Option D is incorrect because the mistake should be addressed within the documentation itself, not by informing the client directly about it.
In what order should the LPN see the following clients? Use appropriate letters to match the correct order
- A. A, D, B, C
- B. C, B, D, A
- C. D, C, B, A
- D. B, C, A, D
Correct Answer: B
Rationale: The correct order for the LPN to see the clients is C, B, D, A. It is crucial to prioritize client care based on the urgency of their conditions. The 53-year-old client with lower leg swelling complaining of sudden onset headache and blurry vision (Client C) should be seen first as they are at the highest risk for serious healthcare complications. Next, the LPN should attend to the 23-year-old client with a left arm fracture after an MVA complaining of significant pain in his arm (Client B). Following that, the LPN can address the 47-year-old client requesting more information regarding her surgery scheduled in three hours (Client D). Lastly, the LPN should attend to the 72-year-old client with pneumonia asking to order her dinner (Client A). This order ensures that the most critical needs are met first, followed by the less urgent ones. Choice A is incorrect as it places the 72-year-old client before the 23-year-old client with a painful arm. Choice B is incorrect as it prioritizes the 53-year-old client last. Choice D is incorrect as it does not address the urgency of the clients' conditions appropriately.