Nursing Elites

1. A client is admitted to a nursing unit with a remittent fever. Which statement best describes this pattern of fever?

• A. A fever that spikes and then lowers without returning to normal
• B. A fever that lasts 2 days followed by normal temperature for 2 days, followed by fever again
• C. A fever that lasts 2 days followed by normal temperature for 12 hours, followed by fever again
• D. A persistent fever that has lasted over 24 hours

Correct answer: A

Rationale: A remittent fever is characterized by temperature fluctuations where the fever spikes and then lowers but does not return to normal temperature. Option A best describes this pattern of fever. Option B describes a pattern of fever known as a biphasic fever, where the fever alternates between days of fever and normal temperature. Option C describes a pattern of fever that is more indicative of an intermittent fever, where the fever lasts for a specific duration followed by an interval of normal temperature. Option D does not accurately describe a remittent fever, as it suggests a persistent fever that has lasted over 24 hours, which is not specific to the remittent pattern.

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. You are caring for an infant who is just about 12 months old. Which assessment data is normal for the infant at this age?

• A. The infant had doubled their birth weight at twelve months.
• B. The infant had tripled their birth weight at twelve months.
• C. The mother reports that the infant is drinking 60 mLs per kilogram of its body weight.
• D. The infant had grown � inch since last month.

Correct answer: A

Rationale: The normal assessment data for the infant at 12 months of age is that the infant has doubled their birth weight at 12 months of age. The mother's reports that the infant is drinking 60 mLs per kilogram of its body weight and the fact that the infant had grown � inch since last month are not normal assessment data. Infants are fed breast milk or formula every two to four hours with a total daily intake of 80 to 100 mLs per kilogram of body weight. As the neonate grows, they gain five to seven ounces during the first six months and then they double their birth weight during the first year; the head circumference increases a half inch each month for six months and then two tenths of an inch until the infant is one year of age. Similarly, the height or length of the newborn increases an inch a month for the first 6 months and then 1/2 inch a month until the infant is 1 year of age.

4. A group of nurses who work on the quality assurance council of a unit have gathered to discuss ideas about how to educate their coworkers about Joint Commission requirements. Each of the nurses gives ideas, which are listed together without initial criticism. Eventually, all ideas on the list will be discussed as to their validity. This activity is known as:

• A. Optimizing
• B. Satisficing
• C. Brainstorming
• D. Centralizing

Correct answer: C

Rationale: Brainstorming is the process in which group members generate ideas without immediate criticism or evaluation. This allows for a free flow of creative suggestions. The ideas are then listed together for consideration and discussion of their validity at a later stage. Optimizing, although related to improving efficiency, does not specifically address the initial idea generation process. Satisficing refers to accepting a satisfactory or 'good enough' solution rather than seeking the best possible option, which is not reflective of the scenario described. Centralizing typically refers to consolidating decision-making authority rather than the collaborative idea generation process seen in brainstorming.

5. The nurse is caring for a woman 2 hours after a vaginal delivery. Documentation indicates that the membranes were ruptured for 36 hours prior to delivery. What are the priority nursing diagnoses at this time?

• A. Altered tissue perfusion
• B. Risk for fluid volume deficit
• C. High risk for hemorrhage
• D. Risk for infection

Correct answer: D

Rationale: The correct answer is 'Risk for infection.' When membranes are ruptured for over 24 hours before delivery, there is a significantly increased risk of infection for both the mother and the newborn. Factors such as increased local cytokines, an imbalance in enzyme activity, and increased intrauterine pressure contribute to this risk. 'Altered tissue perfusion' is not the priority in this scenario as there is no indication of compromised blood flow. 'Risk for fluid volume deficit' is not the priority as there are no signs of excessive fluid loss. 'High risk for hemorrhage' is not the priority as the question does not suggest active bleeding as an immediate concern.

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