Nursing Elites

1. A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states she is unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend?

• A. Social worker
• B. Pharmacist
• C. Respiratory therapist
• D. Child protective services

Correct answer: A

Rationale: The correct answer is A: Social worker. A social worker can assist the parent in finding resources to afford the nebulizer. While a pharmacist may provide information about medications and devices, they may not have direct resources to address financial concerns. A respiratory therapist focuses on respiratory care but may not specialize in financial assistance. Referring to child protective services is not appropriate in this scenario as the parent's inability to afford a nebulizer does not indicate neglect or abuse.

2. A nurse in a clinic is reviewing laboratory reports for a group of clients. Which of the following diseases should the nurse report to the state health department?

• A. Pertussis
• B. Group B streptococcal disease
• C. Respiratory syncytial virus
• D. Rotavirus

Correct answer: A

Rationale: Pertussis is the correct answer because it is a reportable disease that healthcare providers are required by law to report to public health authorities. This infectious disease poses a significant public health risk and needs to be monitored closely to prevent outbreaks and implement control measures. Group B streptococcal disease, Respiratory syncytial virus, and Rotavirus are important conditions but are not typically reportable to the state health department. These diseases may require specific precautions in healthcare settings, but they do not fall under mandatory reporting requirements.

3. What is the significance of patient advocacy in nursing?

• A. Prioritizing the needs of the healthcare team over the patient
• B. Ensuring that patients' rights and preferences are respected
• C. Limiting patient autonomy
• D. Focusing solely on clinical procedures

Correct answer: B

Rationale: Patient advocacy in nursing entails ensuring that patients' rights and preferences are respected. This involves advocating for the patients' best interests, supporting informed decision-making, and safeguarding their autonomy. Choice A is incorrect because patient advocacy focuses on the patient's needs, not the healthcare team's. Choice C is incorrect as patient advocacy aims to empower patients and enhance their autonomy rather than limiting it. Choice D is incorrect since patient advocacy goes beyond clinical procedures to encompass holistic care that addresses the patients' preferences and rights.

4. A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

• A. Withhold the benzodiazepine but continue the opioid
• B. Contact the provider about replacing the opioid with an NSAID
• C. Administer the benzodiazepine but withhold the opioid
• D. Continue the medication dosages that relieve the client's pain

Correct answer: B

Rationale: The correct action for the nurse to take is to contact the provider about replacing the opioid with an NSAID. In this scenario, the client is experiencing excessive sedation after the administration of both opioid and benzodiazepine. Switching to a non-opioid analgesic like an NSAID can help manage pain effectively without causing additional sedation. Option A is incorrect because continuing the opioid may exacerbate sedation. Option C is incorrect as administering the benzodiazepine may further increase sedation. Option D is incorrect because maintaining the current medication dosages that are causing excessive sedation is not in the client's best interest.

5. The wound irrigation process cleanses the wound and:

• A. Reduces the potential pain in the wound region or area.
• B. Stops the spread of infection by creating a 'clean' area.
• C. Pushes extravasated blood from a hematoma into nearby healthy tissue.
• D. Allows for the introduction of medications in solution form.

Correct answer: D

Rationale: The correct answer is D because wound irrigation allows for the introduction of medications in solution form to the wound site. Choice A is incorrect because while wound irrigation can help with pain management indirectly by promoting healing, its primary purpose is not to reduce pain directly. Choice B is incorrect as wound irrigation primarily aims to cleanse the wound and remove contaminants rather than creating a 'clean' area to stop infection spread. Choice C is incorrect because wound irrigation does not involve pushing extravasated blood from a hematoma into nearby healthy tissue; its main goal is to cleanse the wound and promote healing.

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