Nursing Elites

1. A nurse in a mental health unit is preparing to terminate the nurse-client relationship with a client who no longer requires care. Which concept should the nurse and client discuss in the termination phase of the relationship?

• A. Loss
• B. Autonomy
• C. Confidentiality
• D. Accountability

Correct answer: A

Rationale: In the termination phase of a nurse-client relationship, discussing 'loss' is crucial to help the client understand and process the end of the therapeutic relationship and any emotional impact. This discussion can aid in closure and transitioning out of the professional relationship. 'Autonomy' refers to the client's right to make decisions about their care, which is important throughout the relationship but not specifically in the termination phase. 'Confidentiality' is essential for maintaining trust but is not the primary focus during termination. 'Accountability' involves being answerable for one's actions, which is important in nursing practice but not a central topic in the termination phase of the relationship.

2. What immediate action should a healthcare worker take after being stuck in the hand by an exposed needle?

• A. Look up the policy on needle sticks
• B. Contact employee health services
• C. Immediately wash the hands thoroughly with soap and water
• D. Notify the supervisor and risk management

Correct answer: C

Rationale: The correct immediate action for a healthcare worker who has been stuck by an exposed needle is to wash the hands thoroughly with soap and water to reduce the risk of infection. This helps to remove any potential pathogens introduced by the needle stick. Looking up the policy on needle sticks (Choice A) is important but not the immediate action required. Contacting employee health services (Choice B) and notifying the supervisor and risk management (Choice D) are crucial steps to take, but they should follow the initial step of washing the hands to mitigate the risk of infection.

3. A nurse is reviewing the correct use of a fire extinguisher with a client. Which of the following actions should the nurse direct the client to take first?

• A. Remove the safety pin from the extinguisher.
• B. Aim the extinguisher at the base of the fire.
• C. Squeeze the handle to release the extinguishing agent.
• D. Sweep the extinguisher from side to side.

Correct answer: A

Rationale: The correct first step in using a fire extinguisher is to remove the safety pin. This action enables the extinguisher to be activated and used effectively. Choice B, aiming the extinguisher at the base of the fire, comes after removing the safety pin. Choice C, squeezing the handle to release the extinguishing agent, and choice D, sweeping the extinguisher from side to side, are subsequent steps in using a fire extinguisher and should follow removing the safety pin.

4. What intervention should be taken to minimize the risk for injury in a client with dementia?

• A. Use a bed exit alarm system.
• B. Place the client in restraints for safety.
• C. Ensure the client has frequent visitors to reduce isolation.
• D. Keep the client's room dark and quiet at night.

Correct answer: A

Rationale: The correct intervention to minimize the risk for injury in a client with dementia is to use a bed exit alarm system. Bed exit alarms are effective tools to alert healthcare providers when a client attempts to get out of bed, helping prevent falls and injuries. Placing the client in restraints (Choice B) is not the preferred method as it can lead to physical and psychological harm, restrict mobility, and increase agitation. While social interaction is important for clients with dementia, ensuring frequent visitors (Choice C) is not directly related to preventing physical injuries. Keeping the client's room dark and quiet at night (Choice D) may be soothing for some clients but does not directly address the risk for injury associated with dementia.

5. During a neurologic examination, which assessment should a nurse perform to test a client's balance?

• A. Romberg test
• B. Heel-to-toe walk
• C. Snellen test
• D. Spinal accessory function

Correct answer: A

Rationale: The Romberg test is used to assess a client's balance by evaluating their ability to maintain a steady posture with eyes closed. The heel-to-toe walk is another assessment that tests balance by assessing gait and coordination. The Snellen test is used to assess visual acuity and is unrelated to balance. Testing spinal accessory function involves assessing the movement of the head and shoulders and is not directly related to balance assessment.

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