Nursing Elites

1. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?

• A. Document the surgeon's instructions in the client's medical record.
• B. Complete an incident report.
• C. Consult the charge nurse.
• D. Notify the nursing manager.

Correct answer: D

Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.

2. When a client with a terminal diagnosis asks about advance directives, what should the nurse do?

• A. Engage the client and ask why they want to discuss this without their partner present.
• B. Provide information on advance directives and offer brochures.
• C. Advise the client to schedule a discussion with their provider.
• D. Focus on the client's current feelings and postpone planning for a later time.

Correct answer: A

Rationale: Choice A is the correct response as it demonstrates active listening and empathy by engaging the client in a discussion about their concerns regarding advance directives. It also recognizes the importance of involving the client's partner in such discussions, promoting shared decision-making and support. Choices B and C lack the personalized approach needed in this situation and do not address the client's immediate request for information. Choice D is incorrect as it disregards the client's expressed need to discuss advance directives and focuses solely on their current feelings, delaying a crucial conversation.

3. Which of the following conditions would be well suited to the use of a nursing critical pathway?

• A. Foreign object in the ear
• B. Fever of unknown origin
• C. Hip replacement surgery
• D. Bacterial infection acquired in a foreign country

Correct answer: C

Rationale: A critical pathway is designed to track a patient's progress through a specific timeline, including assessments, interventions, treatments, and outcomes. Hip replacement surgery is well suited for a nursing critical pathway because it has a defined timeline with specific interventions and treatments aimed at achieving optimal functioning. Choices A, B, and D do not typically follow a structured timeline with predetermined interventions and outcomes, making them less suitable for a critical pathway.

4. A nurse is caring for a client after knee replacement surgery. The nurse discovers that the consent was not signed before the surgery. Which of the following charges could be filed?

• A. False imprisonment
• B. Libel
• C. Battery
• D. Malpractice

Correct answer: C

Rationale: The correct answer is C: Battery. Battery occurs when an individual is touched without consent. Performing surgery without a signed consent constitutes battery as it involves touching the patient's body without proper authorization. False imprisonment (choice A) involves restraining someone against their will, which is not applicable in this scenario. Libel (choice B) refers to written defamation, which is not relevant to the situation described. Malpractice (choice D) involves negligence or incompetence in providing professional services, which is different from the lack of consent issue presented in this case.

5. A registered nurse (RN) who usually uses public transportation has not renewed her driver’s license. During a recent car trip with a friend, she took over driving when her friend became tired. Which of the following is true?

• A. She has acted in a professional manner.
• B. She may lose her RN license for driving without a license.
• C. She should renew her driver’s license as soon as possible.
• D. Under the circumstances, she will not be faulted for driving without a license.

Correct answer: B

Rationale: Driving without a license is deemed an unprofessional and illegal behavior for which a nurse may lose his or her license.

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