Nursing Elites

1. A nurse is performing an end-of-shift count of narcotics kept in the locked cabinet. The narcotic log states there should be 26 oxycodone pills left, but there are only 24 in the drawer. What is the first action of the nurse?

• A. Perform the count again
• B. Contact the pharmacy to determine if the narcotic log is incorrect
• C. Check with the last nurse to sign out narcotics from the system
• D. Notify the house supervisor that narcotic medications are missing

Correct answer: A

Rationale: The first action the nurse should take in this situation is to perform the count again. This step is crucial to ensure there was no miscount during the initial check. By verifying the count, the nurse can confirm if there is indeed a discrepancy in the number of oxycodone pills. Contacting the pharmacy, checking with the last nurse, or notifying the house supervisor should only be considered after ensuring the count is accurate. It's important to rule out any human error before escalating the issue to others.

2. If a healthcare professional prevents intentional harm from occurring to a patient, which ethical principle is being supported?

• A. Beneficence
• B. Nonmaleficence
• C. Justice
• D. Fidelity

Correct answer: B

Rationale: The correct answer is Nonmaleficence. Nonmaleficence is the ethical principle that emphasizes the obligation to avoid causing harm intentionally. In this scenario, by preventing intentional harm to a patient, the healthcare professional is upholding the principle of nonmaleficence. Beneficence, although important, focuses on doing good and promoting well-being rather than solely preventing harm. Justice relates to fairness and equality in resource distribution, while fidelity involves being faithful and keeping promises, which are not directly applicable to the situation of preventing intentional harm to a patient.

3. What is a key principle of patient teaching that must take place to ensure patient safety?

• A. Family members should be present
• B. Teaching must be documented
• C. Understanding must be confirmed
• D. Teaching should be provided by multiple staff members

Correct answer: C

Rationale: A key principle of patient teaching that ensures patient safety is the confirmation of understanding. To ensure patient safety, it is crucial to confirm that the patient comprehends the information provided. This confirmation can be achieved by having the patient repeat back the information or demonstrate understanding through return demonstration. Documenting the patient's understanding is essential to track the effectiveness of the teaching session and ensure that the patient is equipped with the necessary knowledge for their safety. Family members being present or having multiple staff members provide teaching may be beneficial in certain situations, but the primary focus should be on confirming the patient's understanding to enhance safety and promote effective learning.

4. Which of the following components is associated with hypertonic dehydration?

• A. Plasma sodium levels above 150 mEq/L
• B. Fluid moves from extracellular space to intracellular space
• C. Water loss is greater than electrolyte loss
• D. Physical signs and symptoms are grossly apparent

Correct answer: C

Rationale: The correct answer is 'Water loss is greater than electrolyte loss.' In hypertonic dehydration, there is a higher loss of water compared to electrolytes, leading to elevated concentrations of electrolytes in the body. This condition is characterized by plasma sodium levels above 150 mEq/L. As water moves from the extracellular space to the intracellular space, it results in cellular dehydration. Choice A is incorrect because the plasma sodium levels associated with hypertonic dehydration are typically above 150 mEq/L, not between 130 and 150 mEq/L. Choice B is incorrect as fluid moves from the extracellular space to the intracellular space in hypertonic dehydration. Choice D is incorrect because physical signs and symptoms may not always be grossly apparent in hypertonic dehydration.

5. A nurse is caring for an in-patient client in the hospital who is from another country and who fasts for temporary periods in order to promote his own spiritual growth. The nurse responds by saying, 'You need to eat something while you are here. Food and proper nutrition are extremely important for your health.' What social philosophy is the nurse demonstrating?

• A. Ethnocentrism
• B. Relativism
• C. Stereotyping
• D. Xenocentrism

Correct answer: A

Rationale: The nurse's response reflects ethnocentrism, a belief that one's own cultural practices are superior to others. Ethnocentrism involves viewing one's own culture as the standard by which all others should be judged. In this scenario, the nurse's insistence that the client needs to eat disregards the client's cultural and spiritual beliefs, considering only the nurse's perspective as valid. B: Relativism is the recognition and acceptance of cultural differences without judgment. The nurse's behavior does not align with relativism as there is a lack of understanding and acceptance of the client's cultural practices. C: Stereotyping involves making assumptions about individuals based on predefined characteristics. While the nurse may have made assumptions, the core issue in this scenario is the belief in the superiority of one's own cultural practices. D: Xenocentrism is the opposite of ethnocentrism, where one perceives other cultures as superior to their own. The nurse's actions are not driven by a belief in the superiority of the client's culture but rather by a belief in the superiority of her own cultural practices.

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