Nursing Elites

1. A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?

• A. Wear an N95 respirator when giving direct care to the client.
• B. Place the client in a private room with negative-pressure airflow.
• C. Ensure the client's room has at least six air exchanges per hour.
• D. Ensure the client wears a mask when outside their room if there is construction in the area.

Correct answer: A

Rationale: In a protective environment for a client with an allogeneic stem cell transplant, the nurse needs to wear an N95 respirator when providing direct care to the client. This precaution is essential to protect the client, whose immune system is compromised after the transplant, from exposure to potential pathogens. Placing the client in a private room with negative-pressure airflow (choice B) is more appropriate for clients with airborne infections. Ensuring the client's room has sufficient air exchanges (choice C) is important for maintaining air quality but is not the primary precaution for protecting an immunocompromised client. Making the client wear a mask when outside the room due to construction (choice D) focuses on external factors and does not directly address the risk of infection during direct care.

2. Which of the following is an example of a primary prevention strategy in public health?

• A. Screening for diabetes
• B. Vaccination programs
• C. Emergency response planning
• D. Chronic disease management

Correct answer: B

Rationale: The correct answer is B. Vaccination programs are considered a primary prevention strategy in public health because they aim to prevent the occurrence of diseases before they occur. Screening for diabetes (choice A) is more of a secondary prevention strategy that aims to detect and treat the disease early. Emergency response planning (choice C) is more focused on preparedness and response rather than preventing the initial occurrence of health issues. Chronic disease management (choice D) involves treating and controlling diseases that have already developed, making it a tertiary prevention strategy rather than primary.

3. When using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?

• A. Position the client in a side-lying position.
• B. Perform the irrigation using a 20-mL syringe.
• C. Instill 15 mL of irrigation fluid into the catheter with each flush.
• D. Measure and record the amount of irrigant used.

Correct answer: B

Rationale: When irrigating an indwelling urinary catheter, the nurse should use a 20-mL syringe for the procedure. This syringe size helps to provide adequate pressure for effective irrigation. Placing the client in a side-lying position is not necessary for this procedure. Instilling a specific amount of irrigation fluid into the catheter is not mentioned in the scenario. Subtracting the amount of irrigant used from the client's urine output is not a standard practice in catheter irrigation.

4. What is a common barrier to effective delegation?

• A. Lack of trust in team members
• B. Lack of communication
• C. Inadequate training
• D. Lack of resources

Correct answer: A

Rationale: One of the common barriers to effective delegation is a lack of trust in team members. Delegating tasks involves entrusting responsibilities to others, and without trust in the team members' capabilities, the delegator may struggle to effectively assign tasks. Trust is essential for successful delegation as it allows for empowerment and accountability within the team. While lack of communication is crucial for effective delegation, the lack of trust has a more profound impact as it directly affects the ability to delegate tasks. Inadequate training and lack of resources, although important factors, are not as fundamental as trust in team members when it comes to effective delegation.

5. What is the role of the Joint Commission in healthcare?

• A. Advocacy for patients
• B. Setting standards for patient care
• C. Providing direct patient care
• D. Approving healthcare facilities

Correct answer: D

Rationale: The correct answer is D: 'Approving healthcare facilities.' The Joint Commission's primary role is to accredit and certify healthcare organizations and programs in the United States. This accreditation ensures that healthcare facilities meet specific quality and safety standards. Choices A, B, and C are incorrect because the Joint Commission focuses on evaluating and accrediting healthcare facilities rather than advocating for patients, providing direct care, or setting standards for patient care.

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