Nursing Elites

1. A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse implement for this client?

• A. Have the client wear a mask when receiving visitors.
• B. Limit the client's time with visitors to no more than 30 minutes per day.
• C. Assign the client to a room with negative-pressure airflow exchange.
• D. Wear a gown when caring for the client.

Correct answer: B

Rationale: The correct answer is B because limiting the client's time with visitors helps prevent the spread of shigella infection to others. Shigella is transmitted through the fecal-oral route, so minimizing contact time reduces the risk of transmission. Choice A is incorrect as there is no need for the client to wear a mask in this situation. Choice C is also incorrect as negative-pressure airflow exchange rooms are typically used for clients with airborne infections. Choice D is incorrect as wearing a gown is not the primary precaution needed for shigella infection.

2. A nurse is assessing a client who reports increased pain following physical therapy. Which of the following questions should the nurse ask when assessing the quality of the client's pain?

• A. Is your pain constant or intermittent?
• B. What would you rate your pain on a scale of 0 to 10?
• C. Does the pain radiate?
• D. Is your pain sharp or dull?

Correct answer: D

Rationale: When assessing the quality of pain, asking if the pain is sharp or dull helps the nurse understand the nature of the pain. Sharp pain is often associated with acute conditions like nerve irritation or injury, while dull pain may indicate a more chronic issue like inflammation or tissue damage. Choices A, B, and C focus on different aspects of pain assessment but do not specifically address the quality of pain, making them less relevant in this context.

3. What is the main focus of a risk management program in healthcare?

• A. To reduce hospital readmissions
• B. To manage financial resources
• C. To ensure compliance with healthcare regulations
• D. To improve clinical outcomes

Correct answer: D

Rationale: The main focus of a risk management program in healthcare is to improve clinical outcomes. By identifying and mitigating risks, healthcare organizations aim to enhance patient safety, quality of care, and overall health outcomes. Option A is incorrect because reducing hospital readmissions is a specific goal within healthcare but not the primary focus of risk management. Option B is incorrect as managing financial resources, while important, is more aligned with financial management rather than risk management. Option C is incorrect as ensuring compliance with healthcare regulations is vital but falls under compliance management rather than the primary focus of risk management, which is to improve clinical outcomes.

4. An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?

• A. Hemoglobin A1C level 6.2%
• B. Blood pressure 146/88 mmHg
• C. Heart rate at rest 58 beats/minute
• D. High-density lipoprotein (HDL) level 65 mg/dL

Correct answer: B

Rationale: The correct answer is B. In a young adult with type 1 diabetes, a blood pressure of 146/88 mmHg may indicate the need for a change in therapy as it is above the recommended target levels. High blood pressure can increase the risk of cardiovascular complications in diabetic patients. Choices A, C, and D are within normal ranges and do not necessarily indicate the need for an immediate change in therapy. A Hemoglobin A1C level of 6.2% is generally considered good control for a diabetic patient, a resting heart rate of 58 beats/minute is normal for an active individual, and an HDL level of 65 mg/dL is considered to be in the desirable range for heart health.

5. The process by which registered nurses assess and judge the performance of peers against some predetermined standard is called:

• A. Group evaluation.
• B. Peer review.
• C. Forced distribution evaluation.
• D. Essay evaluation.

Correct answer: B

Rationale: The correct answer is B: Peer review. Peer review is a process in which professional peers assess and judge the performance of their colleagues against predetermined standards. Essay evaluations involve describing an employee's performance through a detailed written narrative. Forced distribution evaluation is a method where employees are rated based on a fixed distribution, similar to grading on a curve. Group evaluation, on the other hand, involves managers comparing individual and group performance against organizational standards.

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