Nursing Elites

1. A nurse at a long-term care facility is part of a team preparing a report on the quality of care at the facility. Which of the following information should the nurse recommend including in the report to demonstrate improvement in care quality?

• A. Increased admissions
• B. 12% fewer urinary tract infections
• C. Increased mortality rate
• D. No changes in staffing

Correct answer: B

Rationale: The correct answer is B: '12% fewer urinary tract infections.' Tracking infections, such as UTIs, is crucial in assessing care quality improvements as the reduction in infections indicates better infection control practices and overall quality of care. Choices A, C, and D are incorrect. Increased admissions (Choice A) do not directly reflect improvements in care quality. Increased mortality rate (Choice C) is a negative outcome and demonstrates a decline in care quality. No changes in staffing (Choice D) do not provide direct evidence of care quality improvements.

2. What are the principles of aseptic technique in wound care?

• A. Use sterile gloves and a clean dressing
• B. Apply a clean dressing using sterile scissors
• C. Wash hands thoroughly before applying the dressing
• D. Use a clean glove and avoid contact with the wound

Correct answer: A

Rationale: The correct answer is A: 'Use sterile gloves and a clean dressing.' Aseptic technique in wound care requires the use of sterile gloves to prevent infection. Choice B is incorrect as the method of application does not primarily focus on maintaining asepsis. Choice C, while important for infection control, is not specific to aseptic technique in wound care. Choice D is incorrect because using a single clean glove does not ensure the level of sterility needed for aseptic wound care.

3. What are the signs of hypoglycemia, and how should a healthcare provider respond to a patient experiencing this condition?

• A. Shakiness or Tremors
• B. Confusion or Irritability
• C. Hunger
• D. Dizziness or Lightheadedness

Correct answer: A

Rationale: The signs of hypoglycemia include shakiness, confusion, hunger, dizziness, and lightheadedness. However, the classic and most common early sign is shakiness or tremors. When a patient is experiencing hypoglycemia, a healthcare provider should respond promptly by administering glucose to raise the blood sugar levels. Choice A is correct as it directly addresses one of the primary signs of hypoglycemia. Choices B, C, and D are incorrect because while confusion, irritability, hunger, dizziness, and lightheadedness can also be signs of hypoglycemia, shakiness or tremors are the classic and most common early symptoms that healthcare providers should be particularly vigilant for.

4. What are the common complications of diabetes, and how should they be managed?

• A. Retinopathy and nephropathy; manage with regular screening
• B. Neuropathy and cardiovascular disease; manage with medication
• C. Foot ulcers and hypertension; manage with proper foot care
• D. Hypertension and liver disease; manage with insulin therapy

Correct answer: A

Rationale: The correct answer is A. Common complications of diabetes include retinopathy (damage to the retina) and nephropathy (kidney damage). These complications can be managed effectively with regular screening to detect any signs early on. Choice B is incorrect as neuropathy and cardiovascular disease are other complications of diabetes but are managed through various treatments and lifestyle modifications, not just medication. Choice C is incorrect as although foot ulcers and hypertension are associated with diabetes, the management involves proper foot care practices and blood pressure control, respectively. Choice D is incorrect as hypertension and liver disease are not the typical complications of diabetes, and insulin therapy is not the primary management for these conditions.

5. A client is receiving phenytoin for management of grand mal seizures and has a new prescription for isoniazid and rifampin. Which of the following should the nurse conclude if the client develops ataxia and incoordination?

• A. The client is experiencing an adverse reaction to rifampin.
• B. The client's seizure disorder is no longer under control.
• C. The client is showing evidence of phenytoin toxicity.
• D. The client is having adverse effects due to combination antimicrobial therapy.

Correct answer: C

Rationale: Ataxia and incoordination are signs of phenytoin toxicity rather than adverse reactions to rifampin or isoniazid. These symptoms indicate that the client is experiencing an adverse effect of phenytoin, requiring a dose adjustment. Choice A is incorrect because rifampin is not typically associated with ataxia and incoordination. Choice B is incorrect as the development of ataxia and incoordination does not necessarily mean the seizure disorder is no longer under control. Choice D is incorrect as the symptoms are more indicative of phenytoin toxicity rather than adverse effects of combination antimicrobial therapy.

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