Nursing Elites

1. A nurse is admitting a client who has an abdominal wound with a large amount of purulent drainage. Which of the following types of transmission precautions should the nurse initiate?

• A. Droplet precautions
• B. Protective environment
• C. Airborne precautions
• D. Contact precautions

Correct answer: D

Rationale: The correct answer is D: Contact precautions. Contact precautions are used when there is a risk of transmission of infections through direct or indirect contact. In this scenario, the client has an abdominal wound with purulent drainage, indicating a potential for infection transmission through contact. Droplet precautions (choice A) are used for infections transmitted through respiratory droplets, such as influenza. Protective environment (choice B) is used for immunocompromised clients. Airborne precautions (choice C) are used for infections transmitted through small droplets that remain in the air, like tuberculosis. Therefore, in this case, the nurse should initiate contact precautions to prevent the spread of infection.

2. The changes brought forth by the state boards of nursing are an example of which type of change agent?

• A. Resistance
• B. Empirical–rational
• C. Normative–reeducative
• D. Power–coercive

Correct answer: D

Rationale: The changes implemented by state boards of nursing typically fall under the category of Power–coercive change agents. State boards of nursing have the authority to enforce changes through regulations and policies, making use of their legitimate power. Resistance (choice A) is not the correct answer as it refers to opposition to change rather than the entity driving change. Empirical–rational (choice B) focuses on convincing individuals through empirical evidence and rational arguments, which is not reflective of the state boards' authority. Normative–reeducative (choice C) involves persuading individuals to change based on shared values and beliefs, which is not the primary approach of state boards of nursing.

3. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?

• A. Urine is positive for ketones
• B. Urine has an unusual odor
• C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
• D. Bladder scan shows 525 mL of urine

Correct answer: A

Rationale: The correct answer is A. Ketones in the urine may indicate infection or blockage in the urinary catheter, necessitating irrigation to ensure proper drainage. Choice B, an unusual odor in the urine, may suggest infection but does not directly indicate the need for catheter irrigation. Choice C, a high urine specific gravity, is indicative of concentrated urine but does not specifically point to the need for catheter irrigation. Choice D, a bladder scan showing 525 mL of urine, indicates urine retention, which may require catheterization or further assessment but not necessarily irrigation.

4. Which of the following best describes the concept of holistic nursing?

• A. An approach that integrates the mind, body, and spirit in patient care
• B. A method that focuses solely on physical health
• C. A practice that considers only the patient's physical condition
• D. A framework for improving hospital administration

Correct answer: A

Rationale: The correct answer is A: 'An approach that integrates the mind, body, and spirit in patient care.' Holistic nursing is a comprehensive approach that considers the whole person, including their physical, emotional, social, and spiritual well-being. Choice B is incorrect because holistic nursing goes beyond just physical health. Choice C is incorrect because holistic nursing considers various aspects of the patient, not just the physical condition. Choice D is incorrect because holistic nursing is focused on patient care and well-being, not hospital administration.

5. A healthcare professional is admitting a client who has rubella. Which of the following types of transmission-based precautions should the nurse initiate?

• A. Airborne
• B. Protective environment
• C. Contact
• D. Droplet

Correct answer: B

Rationale: The correct answer is 'B: Protective environment.' Rubella requires placing the client in a protective environment due to its airborne precautions. Airborne precautions are typically used for diseases that are spread through tiny droplets that remain in the air for an extended period, like tuberculosis. Contact precautions are used for diseases that are spread by direct or indirect contact, such as MRSA. Droplet precautions are implemented for diseases transmitted through respiratory droplets, like influenza. Therefore, in the case of rubella, airborne precautions in a protective environment are necessary.

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