Nursing Elites

1. A nurse at a long-term care facility is planning a fall prevention program for the residents. Which of the following interventions should the nurse include?

• A. Apply vest restraints to residents who are confused
• B. Keep all four side rails up on beds at night
• C. Accompany residents over 85 years of age during ambulation
• D. Implement rounds every 2 hours during the day to offer toileting

Correct answer: D

Rationale: The correct answer is to implement rounds every 2 hours during the day to offer toileting. This intervention helps prevent falls by addressing the common cause of unassisted mobility, which is the need to use the bathroom. Choice A is incorrect as restraints should not be the first choice for fall prevention due to the risk of injury and loss of independence. Choice B is incorrect because all side rails up can lead to entrapment and should only be used based on individualized assessments. Choice C may not be feasible for all residents over 85 years old and does not directly address the risk of falls.

2. You have just learned that another nurse was fired for taking photographs of patients without their permission using a cell phone and posting them on Facebook. This nurse was fired because the nurse had:

• A. Violated the law
• B. Acted in a negligent manner
• C. Not completed the proper documentation
• D. Violated an ethical principle

Correct answer: A

Rationale: The correct answer is A: Violated the law. Taking and sharing patient photographs without consent is a violation of patient privacy laws, hence the nurse was fired for breaking the law. Choice B, acting in a negligent manner, is incorrect as the nurse's actions were intentional and not due to negligence. Choice C, not completing proper documentation, is unrelated to the situation described. Choice D, violating an ethical principle, is not specific enough as the primary reason for the nurse's termination was the legal breach regarding patient privacy.

3. Which of the following is the best way for a nurse to improve quality of care?

• A. Recognize that physicians are among the health-care professionals interested in improving quality of care.
• B. Work with patients and families to improve healthcare.
• C. Collaborate with other health-care professionals, patients, and their families.
• D. Recognize that physicians are among the numerous professionals in health care.

Correct answer: C

Rationale: The best way for a nurse to improve the quality of care is by collaborating with other health-care professionals, patients, and their families. By working together with the healthcare team, patients, and families, nurses can ensure a holistic approach to care delivery, leading to better outcomes. Choices A and D are incorrect as they focus solely on physicians, while choice B, though important, does not fully encompass the collaborative aspect necessary for comprehensive care.

4. Which statement about glaucoma is true and accurate?

• A. Acute angle-closure glaucoma is an ocular emergency.
• B. Acute angle-closure glaucoma leads to the loss of peripheral vision and tunnel vision.
• C. Primary open-angle glaucoma leads to eye pain, nausea, and vomiting, blurry vision, and halos.
• D. Bubbles are implanted to protect the retina from glaucoma.

Correct answer: A

Rationale: The correct answer is A: 'Acute angle-closure glaucoma is an ocular emergency.' Acute angle-closure glaucoma is indeed considered an ocular emergency that requires immediate attention to prevent vision loss. Choice B is incorrect because acute angle-closure glaucoma commonly presents with symptoms like severe eye pain, headache, blurred vision, and halos around lights. Choice C is incorrect as these symptoms are more indicative of acute angle-closure glaucoma rather than primary open-angle glaucoma. Choice D is incorrect since bubbles are not typically used to protect the retina from glaucoma; treatment usually involves medications, laser therapy, or surgery to manage intraocular pressure.

5. Your client is adversely affected with fever, night sweats, occult hematuria, tenderness of the spleen, and Osler's nodes. What disorder would you most likely suspect?

• A. Tuberculosis
• B. AIDS/HIV
• C. Pericarditis
• D. Endocarditis

Correct answer: D

Rationale: The client is likely suffering from endocarditis based on the symptoms described. Endocarditis is characterized by fever, night sweats, hematuria, splenomegaly (tenderness of the spleen), and Osler's nodes (painful nodules on the pads of the fingers or toes). While tuberculosis and AIDS/HIV can present with some similar symptoms, the presence of Osler's nodes is more specific to endocarditis. Pericarditis typically presents with chest pain, not the combination of symptoms seen in this case.

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