Nursing Elites

1. A healthcare professional is considering which patient to admit to the same room as a patient who had a liver transplant 3 weeks ago and is now hospitalized with acute rejection. Which patient would be the best choice?

• A. Patient who is receiving chemotherapy for liver cancer
• B. Patient who is receiving chemotherapy for lung cancer
• C. Patient who has a wound infection after cholecystectomy
• D. Patient who requires pain management for chronic pancreatitis

Correct answer: D

Rationale: The patient with chronic pancreatitis is the best choice to admit to the same room as a patient who had a liver transplant and is experiencing acute rejection. This is because the patient with chronic pancreatitis does not pose an infection risk to the immunosuppressed patient who had a liver transplant. On the other hand, patients receiving chemotherapy for cancer or those with wound infections are at risk for infections, which could endanger the immunosuppressed patient with acute rejection.

2. While performing CPR, a healthcare provider encounters a client with a large amount of thick chest hair when preparing to use an automated external defibrillator (AED). What is the next appropriate action for the healthcare provider?

• A. Apply the pads to the chest and provide a shock
• B. Wipe the client's chest down with a towel before applying the pads
• C. Shave the client's chest to remove the hair
• D. Do not use the AED

Correct answer: C

Rationale: When using an AED, it is crucial for the pads to have good contact with the skin to effectively deliver an electrical shock. While AED pads can adhere to a client's chest even with some hair, thick chest hair can hinder proper current conduction. In such cases, it is recommended to shave the area of the chest where the pads will be applied. Most AED kits include a razor for this purpose. The healthcare provider should act promptly to minimize delays in defibrillation. Option A is incorrect because it may lead to ineffective treatment due to poor pad adherence. Option B is not the best course of action as wiping the chest may not resolve the issue of poor pad contact. Option D is incorrect as not using the AED could jeopardize the client's chance of survival in a cardiac emergency.

3. A student is late for an appointment and has rushed across campus to the health clinic. How should the nurse proceed?

• A. Allow 5 minutes for the student to relax and rest before checking their vital signs.
• B. Check the blood pressure in both arms, expecting a difference in the readings due to the recent exercise.
• C. Immediately monitor the student's vital signs upon arrival at the clinic and then 5 minutes later, recording any differences.
• D. Check the student's blood pressure in the supine position to provide a more accurate reading and allow the student to relax at the same time.

Correct answer: A

Rationale: To ensure an accurate blood pressure reading, it is important for the student to be in a relaxed state. Allowing at least a 5-minute rest period helps reduce anxiety and provides a valid blood pressure measurement. Checking the blood pressure in both arms is unnecessary unless there is a specific reason to suspect an issue, and recent exercise should not significantly impact the readings. Monitoring vital signs immediately upon arrival may not yield accurate results due to the rush and anxiety of the student. Checking blood pressure in the supine position is not necessary in this scenario and does not provide a more accurate reading.

4. Which of the following medical terms means 'surgical fixation of the stomach'?

• A. Abdominorrhaphy
• B. Gastroplasty
• C. Gastropexy
• D. Abdominorrhexis

Correct answer: C

Rationale: The correct answer is 'Gastropexy,' which means 'surgical fixation of the stomach.' This procedure involves surgically fixing the stomach in place. 'Abdominorrhaphy' refers to suturing or repairing the abdomen, not related to fixing the stomach. 'Gastroplasty' is a surgical reconstruction of the abdomen, not specifically related to fixing the stomach. 'Abdominorrhexis' refers to the rupture or tearing of the abdomen, not a surgical fixation procedure.

5. The nursing diagnosis is Risk for impaired skin integrity related to immobility and pressure secondary to pain and presence of a cast. Which of the following desired outcomes should the nurse include in the care plan?

• A. Client will be able to turn self by day 3
• B. Skin will remain intact and without redness during hospital stay
• C. Client will state pain relieved within 30 minutes after medication
• D. Pressure will be prevented by repositioning client every 2 hours

Correct answer: B

Rationale: The correct desired outcome for a nursing diagnosis of 'Risk for impaired skin integrity' is to ensure that the skin remains intact and without redness during the hospital stay. This outcome directly addresses the risk identified in the diagnosis. Option A focuses on addressing immobility, which is not the priority for this diagnosis. Option C deals with pain relief, which is a separate concern. Option D is an intervention involving pressure prevention through repositioning, rather than an outcome related to skin integrity.

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