On finding multiple bruises on a client's arms and back, the nurse suspects that the client is being abused by a daughter who lives with the client. When questioned, the client denies any abuse. Despite the client's denial, the nurse should report the suspected abuse on the basis of which rationale?

The nurse wants peers to see the nurse as a hero.

The nurse has a legal and ethical responsibility to report the suspected abuse.

The client does not want anyone to know what is happening in the client's home.

The client is ashamed to admit to the abuse by the daughter.

Answer and Explanation

The Correct Answer is B

A. Reporting for personal recognition is not appropriate or ethical.
B. Nurses are mandated reporters and have a legal and ethical duty to report suspected abuse.
C. While the client may not want others to know, the nurse's responsibility is to ensure the client's safety.
D. Although the client may feel ashamed, the priority is their safety and wellbeing.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

A. This is an example of primary prevention, which aims to prevent the onset of disease.
B. This is an example of secondary prevention, which involves early detection and diagnosis.
C. Tertiary prevention involves managing and treating existing diseases to prevent complications and improve quality of life, such as administering a nebulized bronchodilator.
D. This is an example of primary prevention through education.

A. Inserting an indwelling urinary catheter. B. Taking an order over the telephone from a physician. C. Bathing a combative client. D. Assessing a client's wound.

Correct Answer is C

Explanation

A. Inserting an indwelling urinary catheter requires specialized training and should only be performed by licensed personnel.
B. Taking an order over the telephone from a physician requires nursing judgment and should not be delegated to unlicensed personnel.
C. Bathing a combative client can be safely delegated to unlicensed assistive personnel (UAP) as it does not require specialized nursing knowledge.
D. Assessing a client's wound requires nursing assessment skills and should not be delegated to unlicensed personnel.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which activity related to respiratory health is an example of tertiary health promotion and illness prevention?

Correct Answer is C

Explanation

The registered nurse on a busy telemetry floor is delegating tasks to an unlicensed assistive person (UAP). Which task is appropriate for the UAP to complete?

Correct Answer is C

Explanation

A charge nurse is making client care assignments. Which of the following tasks should the nurse delegate to assistive personnel (AP)? (Select all that apply.)

Which nursing activity reflects secondary prevention?

A nurse is caring for a client who has a mental health disorder. The client asks about his medications and their effects. The nurse asks the client why he needs to know this. Which of the following nontherapeutic communication techniques is the nurse using?

A nurse using the principle-based approach to client care seeks to avoid causing harm to clients in all situations. What is this principle known as?

Which is an example of nonmaleficence?

A nurse is trying to encourage a client with paraplegia who is depressed and not adhering to the treatment program to join a support group. Which statement by the nurse is most appropriate?