Nursing Elites

1. A nurse walks into a client's room to find the nursing assistant yelling, 'Sit back down or I won't help you eat, and then you will starve!' This type of behavior is known as:

• A. Psychological abuse
• B. Abandonment
• C. Material exploitation
• D. Physical abuse

Correct answer: A

Rationale: The correct answer is A: Psychological abuse. This behavior is classified as psychological abuse, which harms another person through words or threats. The nursing assistant's actions of yelling, making threats, and using food as a form of control fall under psychological abuse. Abandonment (choice B) refers to deserting or leaving a client without care, which is not the case in the scenario. Material exploitation (choice C) involves taking advantage of a person's assets or resources for personal gain, which is not evident here. Physical abuse (choice D) involves causing physical harm, which is not the primary issue in this situation. Therefore, the most appropriate classification for the behavior described in the scenario is psychological abuse.

2. A client is refusing to undergo any more treatments in the hospital and wants to leave against medical advice. When the nurse requests the client to sign an AMA order, the client refuses and leaves. What is the next action of the nurse?

• A. Call security to hold the client until he signs the order
• B. Notify the physician to convince the client to stay
• C. Speak with the client's spouse to persuade him to stay
• D. Allow the client to leave and document the refusal in his chart

Correct answer: D

Rationale: The nurse cannot force the client to stay in the hospital to receive treatment or to sign an AMA order. It is essential to respect the client's autonomy and decision-making capacity. While involving security or pressuring the client through the physician or spouse may seem like options, they are not appropriate in this situation. The nurse should allow the client to leave if they are competent to make that decision, document the refusal in the client's chart to ensure all actions are appropriately documented, and follow institutional policies for patients leaving against medical advice.

3. Asepsis is defined as ________________.

• A. the absence of all microorganisms
• B. the absence of disease-causing germs
• C. a urinary infection
• D. a pathogenic infection

Correct answer: B

Rationale: Asepsis is defined as the absence of disease-causing germs. It is surgical asepsis that is defined as the absence of all microorganisms, including spores. A pathogenic infection is an invasion of the body by a pathogen, or disease-causing germ, and a urinary infection is only one type of infection.

4. In which situation might an occupational health nurse consultation be necessary?

• A. A nurse is injured from using incorrect body mechanics to lift a client
• B. A nurse receives a subpoena to testify in court about a client's case
• C. A client who has been injured in a diving accident needs assistance with planning rehabilitation and surgery
• D. A nursing unit is implementing a new electronic health record system

Correct answer: A

Rationale: An occupational health nurse is involved in assessing the work environment, educating employees about safety practices, and infection control. When a nurse sustains an injury due to incorrect body mechanics, it falls under the purview of an occupational health nurse because they are responsible for documenting such incidents, providing necessary care or treatment, and ensuring that preventive measures are in place to avoid similar accidents in the future. The other options do not directly relate to the role of an occupational health nurse. Testifying in court, assisting a client with rehabilitation, or implementing a new electronic health record system are not typical scenarios where an occupational health nurse would be involved.

5. The nurse is providing disease prevention education to a 63-year-old woman with a negative family history of breast cancer. The nurse recommends the patient schedule mammograms with which frequency?

• A. Every 5 years
• B. Every 10 years
• C. Every other year
• D. Once a year

Correct answer: C

Rationale: Mammograms, along with breast self-examinations and other routine tests, are key for the early diagnosis and treatment of breast cancer. All major societies (WHO, ACS, USPSTF) recommend a screening mammogram every two years in women of this age at average risk of breast cancer. The recommended frequency may change if there are identified family history and significant risk factors. Choosing 'Once a year' is too frequent and not aligned with current guidelines. Opting for 'Every 5 years' or 'Every 10 years' intervals is not adequate for regular breast cancer screening and may increase the risk of cancer progression. Therefore, 'Every other year' is the most appropriate choice for this patient without a family history of breast cancer.

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