Nursing Elites

1. During passive range of motion (ROM) and splinting, the absence of which finding will indicate goal achievement for these interventions?

• A. Atelectasis
• B. Renal calculi
• C. Pressure ulcers
• D. Joint contractures

Correct answer: D

Rationale: The correct answer is D: Joint contractures. When a healthcare provider performs passive ROM and splinting on a patient, the goal is to prevent joint contractures. Joint contractures result from immobility and can lead to permanent stiffness and decreased range of motion. Atelectasis (choice A) is a condition where there is a complete or partial collapse of the lung, commonly due to immobility, but not directly related to passive ROM or splinting. Renal calculi (choice B) are kidney stones and are not typically associated with ROM exercises. Pressure ulcers (choice C) result from prolonged pressure on the skin and are prevented by repositioning the patient, not specifically addressed by ROM and splinting exercises.

2. When a client decides not to have surgery despite significant blockages of the coronary arteries, it is an example of which of the following ethical principles?

• A. Fidelity
• B. Autonomy
• C. Justice
• D. Nonmaleficence

Correct answer: B

Rationale: The correct answer is autonomy. Autonomy is the ethical principle that upholds an individual's right to make decisions about their healthcare, including the choice to refuse treatment or surgery. In this scenario, the client's decision not to have surgery despite the recommendation is an exercise of autonomy. Choice A, fidelity, refers to being faithful and keeping promises, which is not applicable in this situation. Choice C, justice, pertains to fair and equal distribution of resources and treatment, not the individual's right to make decisions. Choice D, nonmaleficence, relates to the obligation to do no harm, which is not directly applicable to the client's decision to refuse surgery.

3. A healthcare professional is preparing for change of shift. Which document or tool should the healthcare professional use to communicate?

• A. SBAR
• B. SOAP
• C. DAR
• D. PIE

Correct answer: A

Rationale: SBAR (Situation, Background, Assessment, Recommendation) is a structured method for communicating critical information during shift changes or handoffs. It helps to ensure important details about a patient's condition and care are effectively communicated. Choice B, SOAP (Subjective, Objective, Assessment, Plan), is a note-taking format used in healthcare to document patient encounters, but it is not specifically designed for shift handoffs. Choice C, DAR (Data, Action, Response), and choice D, PIE (Problem, Intervention, Evaluation), are not commonly used communication tools during shift changes in healthcare settings. Therefore, the correct choice is SBAR for effective communication during shift handoffs.

4. A charge nurse is teaching a newly licensed nurse about the care of a client who has methicillin-resistant Staphylococcus aureus (MRSA). Which of the following statements should the charge nurse identify as an indication that the newly licensed nurse understands the teaching?

• A. I should obtain a specimen for culture and sensitivity after the first dose of an antimicrobial.
• B. MRSA is usually resistant to vancomycin, so another antimicrobial will be prescribed.
• C. I will protect others from exposure when I transport the client outside the room.
• D. To decrease resistance, antimicrobial therapy is discontinued when the client is no longer febrile.

Correct answer: C

Rationale: The correct answer is C. Protecting others from exposure when transporting a client with MRSA is crucial in preventing the spread of infection. This statement demonstrates understanding of infection control measures. Stating that MRSA is usually resistant to vancomycin (choice B) is incorrect; vancomycin is often effective against MRSA. Obtaining a specimen for culture and sensitivity after the first dose of an antimicrobial (choice A) is unnecessary and not indicated. Discontinuing antimicrobial therapy when the client is no longer febrile (choice D) is incorrect because antimicrobial therapy should be completed as prescribed to prevent the development of resistant strains.

5. The nurse is caring for a client with hyperthyroidism. Which finding should the nurse expect to observe in this client?

• A. Weight loss
• B. Cold intolerance
• C. Bradycardia
• D. Dry skin

Correct answer: A

Rationale: Weight loss is a common finding in clients with hyperthyroidism due to increased metabolic activity. Hyperthyroidism leads to an overactive thyroid gland, which results in an increased metabolic rate and often leads to weight loss despite a normal or increased appetite. Cold intolerance (Choice B) is more commonly associated with hypothyroidism, where the body's processes slow down. Bradycardia (Choice C) is a slow heart rate, which is not typically seen in hyperthyroidism; rather, tachycardia or an increased heart rate is more common. Dry skin (Choice D) is also not a typical finding in hyperthyroidism, as the skin is more likely to be warm and moist due to increased metabolic activity.

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