Nursing Elites

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

• A. Wear gloves only
• B. Wear a mask
• C. Wash hands before and after client care
• D. Use an N95 respirator

Correct answer: C

Rationale: The correct precaution for a nurse caring for a client with shigella-induced diarrhea is to wash hands before and after client care. Shigella is a highly contagious bacterium that spreads through contaminated food, water, or contact with infected individuals. While wearing gloves is important when directly handling bodily fluids, hand hygiene is crucial in preventing the transmission of the infection. Wearing a mask or using an N95 respirator is not necessary for preventing the spread of shigella, as it primarily spreads through the fecal-oral route rather than through respiratory droplets.

2. What is a recommended nursing action for a client who experiences short-term memory loss after Electroconvulsive Therapy (ECT)?

• A. Provide cognitive-behavioral therapy
• B. Offer frequent orientation and reassurance
• C. Administer a sedative to improve memory recall
• D. Refer the client to a neurologist for further evaluation

Correct answer: B

Rationale: The correct nursing action for a client experiencing short-term memory loss after ECT is to offer frequent orientation and reassurance. This helps the client feel supported and aids in memory retention. Providing cognitive-behavioral therapy (Choice A) may be beneficial for other conditions but is not the primary intervention for memory loss post-ECT. Administering a sedative (Choice C) is not recommended as it may further affect memory recall. Referring the client to a neurologist (Choice D) for further evaluation is not the initial action needed; offering support and orientation should be the first approach to manage memory issues post-ECT.

3. Which intervention is most effective in preventing postoperative complications?

• A. Encourage the patient to drink fluids.
• B. Ambulate the patient as soon as possible.
• C. Perform deep breathing exercises with the patient.
• D. Encourage the patient to perform range of motion exercises.

Correct answer: B

Rationale: The most effective intervention in preventing postoperative complications is to ambulate the patient as soon as possible. Early ambulation helps prevent complications like deep vein thrombosis and pneumonia by enhancing circulation and preventing respiratory issues. Encouraging the patient to drink fluids, perform deep breathing exercises, or range of motion exercises are beneficial interventions, but ambulation is the priority due to its overall impact on preventing various postoperative complications.

4. Which nursing action will most likely increase a patient's risk for developing a health care-associated infection?

• A. Uses a sterile bottled solution more than once within a 24-hour period.
• B. Uses surgical aseptic technique to suction an airway.
• C. Uses a clean technique for inserting a urinary catheter.
• D. Uses a cleaning stroke from the urinary meatus toward the rectum.

Correct answer: C

Rationale: The correct answer is C. Using a clean technique for inserting a urinary catheter increases the risk for healthcare-associated infections. Invasive procedures like catheter insertion require a sterile technique to prevent introducing pathogens into the urinary tract. Choices A and B demonstrate appropriate infection control measures by emphasizing the use of sterile or aseptic techniques. Choice D represents an incorrect technique that can lead to the introduction of bacteria from the rectum into the urinary tract, potentially causing infections.

5. What is the most appropriate action for a healthcare provider to take when a patient refuses a prescribed medication?

• A. Document the refusal and notify the healthcare provider.
• B. Administer the medication at a later time.
• C. Explain the importance of the medication and its effects.
• D. Respect the patient's right to refuse the medication.

Correct answer: D

Rationale: The correct answer is to respect the patient's right to refuse the medication. It is crucial to uphold the patient's autonomy and decision-making capacity when it comes to their treatment. Administering the medication later without the patient's consent (Choice B) disregards their autonomy and can lead to ethical issues. Documenting the refusal and notifying the healthcare provider (Choice A) is important for legal and continuity of care purposes but should come after respecting the patient's decision. While explaining the importance of the medication (Choice C) is valuable for promoting understanding and compliance, the immediate concern should be respecting the patient's refusal.

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