Nursing Elites

1. A community health nurse is reviewing primary prevention strategies for West Nile virus with a group of clients in a rural health clinic. Which of the following instructions should the nurse include?

• A. Avoid exposure to deer ticks.
• B. Eliminate areas of standing water.
• C. Use a respiratory mask when cleaning bird coops.
• D. Plan outdoor activities after dusk.

Correct answer: B

Rationale: The correct answer is B: 'Eliminate areas of standing water.' This is an essential primary prevention strategy for West Nile virus as it helps prevent the breeding of mosquitoes that spread the virus. Choices A, C, and D are incorrect. Avoiding exposure to deer ticks is more relevant for Lyme disease, using a respiratory mask when cleaning bird coops is not a primary prevention strategy for West Nile virus, and planning outdoor activities after dusk does not directly address the prevention of West Nile virus transmission.

2. A healthcare provider writes a prescription for a medication dose three times the normal range. What should the nurse do?

• A. Administer the medication as prescribed
• B. Question the prescription with the provider
• C. Consult with the pharmacist about the dosage
• D. Delay the medication until verification can be made

Correct answer: B

Rationale: The correct action for the nurse in this situation is to question the prescription with the provider. Administering a medication dose three times the normal range without clarification could pose serious risks to the client. Consulting with the pharmacist about the dosage or delaying the medication until verification can be made are not the initial steps to take; the nurse should first clarify the prescription with the healthcare provider to ensure patient safety.

3. A healthcare provider notices a discrepancy in the narcotics log. What is the appropriate response?

• A. Correct the narcotics log and move on.
• B. Report the discrepancy to the supervisor.
• C. Confront the provider responsible for the discrepancy.
• D. Dispose of the medication and ignore the discrepancy.

Correct answer: B

Rationale: When a healthcare provider notices a discrepancy in the narcotics log, the appropriate response is to report the issue to the supervisor. Reporting discrepancies is crucial to maintain accountability and prevent potential misuse. Choice A is incorrect because simply correcting the log without addressing the underlying issue does not ensure accountability. Choice C is inappropriate as confronting the provider directly may not be the best approach and could lead to a confrontational situation. Choice D is highly inappropriate as ignoring the discrepancy and disposing of medication without proper documentation can lead to serious consequences.

4. What is the most important action for the nurse to take after finding a patient on the floor who reports, 'I fell out of bed'?

• A. Reassess the patient.
• B. Complete an incident report.
• C. Notify the health care provider.
• D. Take no action, as no harm has occurred.

Correct answer: C

Rationale: The most important action for the nurse to take after finding a patient on the floor who reports falling out of bed is to notify the health care provider. This is crucial to ensure that the incident is reported, documented, and that the patient receives necessary follow-up care. Reassessing the patient is important, but notifying the healthcare provider takes precedence to address any potential injuries or issues that may have resulted from the fall. Completing an incident report is necessary, but immediate notification to the healthcare provider is more critical in this situation. Doing nothing is not an appropriate response, as the patient's safety and well-being must be the top priority.

5. A client complains of pain in the leg while in skeletal traction. What is the nurse's priority action?

• A. Increase the pain medication immediately
• B. Check for signs of infection
• C. Reposition the client's leg for comfort
• D. Notify the physician of the client's complaints

Correct answer: B

Rationale: The correct answer is B: Check for signs of infection. In skeletal traction, the priority action for the nurse when a client complains of pain in the leg is to first assess for signs of infection. Pain in skeletal traction can be a symptom of infection or other complications, so checking for signs of infection is crucial before considering other interventions. Increasing pain medication immediately (Choice A) may mask the symptoms of an underlying infection. Repositioning the client's leg for comfort (Choice C) may provide temporary relief but does not address the potential underlying issue. Notifying the physician of the client's complaints (Choice D) is important but assessing for infection should come first to ensure timely and appropriate intervention.

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