Nursing Elites

1. A 31-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate?

• A. MS symptoms may be worse after the pregnancy
• B. Women with MS frequently have premature labor
• C. MS is associated with an increased risk for congenital defects
• D. Symptoms of MS are likely to become worse during pregnancy

Correct answer: A

Rationale: After pregnancy, women with MS are at higher risk for exacerbation of symptoms due to the postpartum period. There is no increased risk for congenital defects in infants born to mothers with MS. Symptoms of MS may actually improve during pregnancy, likely due to hormonal changes. MS does not significantly impact the onset of labor. Therefore, the correct response is that MS symptoms may worsen after pregnancy, making option A the accurate answer. Options B, C, and D are incorrect as they do not accurately reflect the risks associated with pregnancy in individuals with MS.

2. The family of a patient who is receiving therapeutic hypothermia states they do not understand why the patient is being kept so cold. What objective information can you provide to help address their concerns?

• A. Let them talk to another patient who has had the same therapy
• B. Provide research-based information about therapeutic hypothermia
• C. Connect them with the nurse manager
• D. Call the physician and ask him to talk to the family

Correct answer: B

Rationale: Providing research-based information about the benefits of therapeutic hypothermia for their loved one will provide evidence that this is an established therapy with generally positive outcomes. Families are certainly not expected to be familiar with critical care interventions, and their concerns should be addressed with evidence-based data whenever possible. Option A is not appropriate as sharing patient information violates privacy laws and does not address the family's concerns directly. Option C may not directly provide the detailed information the family needs to understand therapeutic hypothermia. Option D involves unnecessary escalation by immediately involving the physician, when providing education and information should be the initial step in addressing the family's concerns.

3. Your patient has been diagnosed with a left ankle sprain. On the discharge instructions, the physician has prescribed the RICE protocol. This acronym stands for:

• A. Rest, Ice, Compression, Elevation
• B. Radiology, Ice, Compression, Elevation
• C. Rest, Ice, Cast, Elevation
• D. Radiology, Ice, Cast, Elevation

Correct answer: A

Rationale: The correct answer is Rest, Ice, Compression, Elevation. This acronym, RICE, is commonly used for the treatment of injuries like an ankle sprain. Rest allows the injured area to heal, Ice helps reduce swelling and pain (20 minutes on each hour while awake), Compression is usually achieved with an elastic bandage to minimize swelling, and Elevation of the foot above the level of the heart assists in reducing swelling and promoting healing. Choices B, C, and D are incorrect because they include irrelevant terms like Radiology and Cast, which are not part of the standard treatment protocol for an ankle sprain.

4. A nurse is using active listening as a form of therapeutic communication when:

• A. She uses humor to put the client at ease in a situation
• B. She restates what the client said in slightly different words
• C. She uses eye contact and maintains an open stance while the client is talking
• D. She provides personal information to show the client she can relate to him

Correct answer: C

Rationale: Active listening is a form of therapeutic communication that involves the nurse encouraging a client to express their thoughts and feelings. Maintaining eye contact and an open stance while the client is talking demonstrates active listening and shows the client that they are being heard and understood. Using humor (Choice A) may not always be appropriate or therapeutic in all situations. Restating what the client said (Choice B) is a technique known as paraphrasing and is also a form of active listening. Providing personal information (Choice D) can shift the focus from the client to the nurse, which is not the intention of active listening.

5. 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.

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