Nursing Elites

1. A nurse is observing a nursing student practicing standard precautions. Which observation by the instructor indicates that further teaching is necessary?

• A. The nursing student wears gloves when changing bed linens.
• B. The nursing student wears gloves to remove a wound dressing.
• C. The nursing student washes hands after removing gloves.
• D. The nursing student touches the patient's skin with sterile gloves.

Correct answer: D

Rationale: The correct answer is D because touching a patient's skin with sterile gloves compromises the sterility of the gloves, increasing the risk of contamination. Choices A, B, and C demonstrate correct practices in standard precautions. Wearing gloves when changing bed linens and to remove a wound dressing, as well as washing hands after removing gloves, are all appropriate and necessary steps to prevent the spread of infection.

2. A patient may need restraints. Which task can the nurse delegate to a nursing assistive personnel?

• A. Determining the need for restraints
• B. Obtaining an order for a restraint
• C. Assessing the patient's orientation
• D. Applying the restraint

Correct answer: D

Rationale: The correct answer is applying the restraint (Choice D). Nursing assistive personnel can be delegated the task of applying restraints under the supervision and direction of a nurse. Determining the need for restraints (Choice A) and obtaining an order for a restraint (Choice B) involve clinical judgment and assessment, which are responsibilities of the nurse. Assessing the patient's orientation (Choice C) also requires a level of assessment that should be performed by a nurse.

3. Which action by the nurse represents the ethical principle of beneficence?

• A. Ensuring all clients are treated fairly
• B. Preventing harm by providing accurate information
• C. Allowing the client to refuse treatment
• D. Ensuring the client's family agrees with the treatment

Correct answer: B

Rationale: The correct answer is B. Beneficence is the ethical principle of doing good or acting in the best interest of the client. Preventing harm by providing accurate information and necessary care aligns with the principle of beneficence, as it focuses on promoting the well-being and safety of the client. Choices A, C, and D do not directly reflect the concept of beneficence. Ensuring all clients are treated fairly relates more to justice, allowing the client to refuse treatment pertains to autonomy, and ensuring the client's family agrees with the treatment involves collaboration and communication but not specifically beneficence.

4. Which of the following is a recommended approach for handling aggressive behavior in a mental health setting?

• A. Encourage the client to express their feelings through physical activity
• B. Avoid making eye contact to prevent escalation
• C. Use pharmacological interventions immediately
• D. Maintain eye contact, offer clear choices, and set boundaries

Correct answer: D

Rationale: The recommended approach for handling aggressive behavior in a mental health setting is to maintain eye contact, offer clear choices, and set boundaries. This approach can help de-escalate the situation by establishing communication and structure. Choice A is incorrect as encouraging physical activity may not be suitable during an aggressive episode. Choice B is incorrect because avoiding eye contact can hinder communication and resolution. Choice C is also incorrect as pharmacological interventions should not be the immediate go-to method for managing aggression unless absolutely necessary.

5. What should be done to ensure safety during the transfer of a patient with limited mobility?

• A. Have the patient use a gait belt for support.
• B. Encourage the patient to hold onto a walker.
• C. Lock the wheels on the bed and wheelchair.
• D. Ask the patient to transfer independently.

Correct answer: C

Rationale: The correct answer is to lock the wheels on the bed and wheelchair. This action helps prevent accidents by stabilizing the equipment during the transfer process. Having the patient use a gait belt for support (choice A) can be helpful but is not directly related to equipment safety. Encouraging the patient to hold onto a walker (choice B) is beneficial for ambulation but does not address the safety of equipment. Asking the patient to transfer independently (choice D) can pose risks, especially for a patient with limited mobility, and may not ensure safety during the transfer.

Similar Questions