Nursing Elites

1. A nurse manager of a rural clinic is orienting a new employee. Which of the following information should the nurse include as a characteristic of rural health?

• A. Lower rates of maternal morbidity
• B. Reduced incidence of death from motor-vehicle crashes
• C. Increased rates of chronic illness
• D. More frequent dental preventative care visits

Correct answer: C

Rationale: The correct answer is C: 'Increased rates of chronic illness.' Rural areas often face challenges such as limited access to healthcare services, healthcare provider shortages, socioeconomic factors, and lifestyle choices that contribute to higher rates of chronic illnesses. Maternal morbidity rates are typically higher in rural areas due to limited access to obstetric care. While rural areas may have fewer motor-vehicle crashes compared to urban areas, the severity of crashes is usually higher due to factors like longer emergency response times. Dental care access can also be limited in rural areas, leading to less frequent preventative care visits.

2. A client reports pain and swelling at the IV site. What should the nurse do first?

• A. Flush the IV line and continue the infusion.
• B. Stop the infusion and notify the healthcare provider.
• C. Increase the IV infusion rate to reduce discomfort.
• D. Apply a warm compress to the IV site and continue monitoring.

Correct answer: B

Rationale: The correct answer is B: Stop the infusion and notify the healthcare provider. Pain and swelling at an IV site can indicate infiltration or infection, which are serious complications. Stopping the infusion helps prevent further harm to the client, and notifying the healthcare provider promptly allows for appropriate assessment and intervention. Choice A is incorrect because flushing the IV line and continuing the infusion could exacerbate the issue. Choice C is incorrect as increasing the IV infusion rate is not the appropriate action for pain and swelling at the site. Choice D is incorrect because applying a warm compress may not address the underlying issue of infiltration or infection; it's crucial to stop the infusion and seek further guidance.

3. What is the most appropriate action for a healthcare professional to take when a medication error occurs?

• A. Document the error in the patient's medical record.
• B. Report the error to the healthcare provider immediately.
• C. Apologize to the patient and explain what happened.
• D. Continue administering the medication and monitor the patient closely.

Correct answer: B

Rationale: When a medication error occurs, the most appropriate action for a healthcare professional is to report the error to the healthcare provider immediately. This is crucial for ensuring prompt corrective action to mitigate any potential harm to the patient. Documenting the error is important but should come after reporting it to the relevant authorities. Apologizing to the patient is important for maintaining trust and communication but should not take precedence over reporting and addressing the error. Continuing to administer the medication without addressing the error is unsafe and goes against patient safety protocols.

4. A client with leukemia is considered for a bone marrow transplant. Which principle of healthcare ethics is being practiced by minimizing harm to the client?

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

Correct answer: C

Rationale: The correct answer is C: Nonmaleficence. Nonmaleficence is the ethical principle that focuses on avoiding harm to the patient. In this scenario, by considering a bone marrow transplant for the client with leukemia, healthcare professionals are practicing nonmaleficence by aiming to minimize harm. Choice A, Justice, pertains to fairness in the distribution of resources and decisions, which is not the primary focus in this situation. Choice B, Beneficence, involves promoting the patient's well-being, which is related but not directly addressing the act of minimizing harm. Choice D, Autonomy, refers to respecting the patient's right to make decisions about their own care, which is not the key principle at play when minimizing harm in this context.

5. A patient reports nausea and vomiting after chemotherapy. What is the nurse's priority action?

• A. Administer an antiemetic as prescribed.
• B. Encourage the patient to eat small, frequent meals.
• C. Provide the patient with anti-nausea wristbands.
• D. Encourage the patient to rest after eating.

Correct answer: A

Rationale: The correct answer is to administer an antiemetic as prescribed. Chemotherapy-induced nausea and vomiting can be distressing for patients. Administering an antiemetic helps alleviate these symptoms effectively. Choice B, encouraging the patient to eat small, frequent meals, may be helpful for other gastrointestinal issues but is not the priority when the patient is experiencing nausea and vomiting. Choice C, providing anti-nausea wristbands, may offer some relief but is not as direct and immediate as administering an antiemetic. Choice D, encouraging the patient to rest after eating, is not the priority in this situation where the focus should be on managing the nausea and vomiting.

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