Nursing Elites

1. What should be the first action upon the discovery of an electrical fire?

• A. Disconnect the electrical power if it can be done safely
• B. Smother the source with an object like a blanket
• C. Saturate the source with water or another liquid
• D. Immediately activate the fire alarm

Correct answer: A

Rationale: The correct initial action upon discovering an electrical fire is to disconnect the electrical power if it can be done safely. This helps prevent the fire from spreading through the electrical system. Smothering the fire with a blanket is not recommended for electrical fires as it can fuel the fire. Saturating the source with water or other liquids is also not advised as it can lead to electric shock or spread the fire. Activating the fire alarm is important, but it should be done after disconnecting the power to prevent further escalation of the fire.

2. The nurse is caring for a client recovering from a stroke who recently regained consciousness. The client is having difficulty communicating verbally with the team. Which of the following actions would be least appropriate?

• A. Begin client data collection before receiving the physician's order for the referral.
• B. Use documents to provide information for the referral.
• C. Wait for the physician's order for speech therapy before assisting with the appropriate documentation.
• D. Participate in the client referral process.

Correct answer: C

Rationale: In this scenario, the least appropriate action would be to wait for the physician's order for speech therapy before assisting with the appropriate documentation. The nurse should start by collecting client data without needing the physician's order, use documents to provide information for the referral, and actively participate in the client referral process. Waiting for the physician's order unnecessarily delays potentially crucial therapy for the client's recovery, affecting the timeliness and effectiveness of care. Therefore, choice C is the least appropriate as immediate action is required in such situations.

3. Which of the following adverse effects should the client on Floxin be alerted to?

• A. stunting of height in teens and young adults
• B. propensity for anovulatory uterine bleeding
• C. intractable diarrhea
• D. tendon rupture

Correct answer: D

Rationale: The correct answer is tendon rupture. Floxin is a quinolone antibiotic commonly used in respiratory infections and pelvic/reproductive infections. One of the rare adverse effects associated with quinolones is tendon sheath rupture, often affecting the Achilles tendon. Therefore, patients taking Floxin should be alerted to the possibility of tendon rupture. Choices A, B, and C are incorrect as they are not typically associated with Floxin use and are not common adverse effects of quinolone antibiotics. Stunting of height is not a recognized adverse effect of Floxin. Anovulatory uterine bleeding is not a known side effect of quinolones. Intractable diarrhea is not a common adverse effect of Floxin.

4. A nurse is taking a morning break with the unit secretary in the nurses' lounge. The unit secretary says to the nurse, 'I read in Mr. Gage's medical record that he has gonorrhea.' How should the nurse respond to the secretary?

• A. Yes, he does, but be sure not to discuss this with anyone else.
• B. Yes, that's why we've imposed contact precautions.
• C. We can't discuss a client's medical condition.
• D. Oh, really? I didn't see that!

Correct answer: C

Rationale: A client's medical condition is confidential and should never be discussed with anyone other than the client and the client's healthcare provider. Therefore, the nurse must tell the unit secretary that the client's condition is not to be discussed. Choices A and B confirm the client's disease, which is inappropriate as it breaches patient confidentiality. Choice D promotes further discussion of the client's condition, which is also inappropriate. The correct response is to firmly state, 'We can't discuss a client's medical condition,' to uphold patient privacy and confidentiality.

5. Why is monitoring Serum Vancomycin levels important?

• A. to assess renal function
• B. to determine therapeutic range
• C. to measure trough levels
• D. to evaluate antibiotic resistance

Correct answer: B

Rationale: Monitoring Serum Vancomycin levels is essential to determine the drug's therapeutic range, ensuring optimal effectiveness while avoiding toxicity. Peak levels indicate the drug's highest concentration, while trough levels represent the lowest concentration before the next dose. Assessing renal function is typically done using creatinine, BUN, or creatinine clearance tests, not Serum Vancomycin levels. Evaluating antibiotic resistance involves sensitivity testing, not monitoring Vancomycin levels. Therefore, the correct answer is to determine the therapeutic range.

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