Nursing Elites

1. While assessing a migrant farm worker in a mobile health clinic, which of the following findings should the nurse identify as the priority?

• A. Report of back pain associated with twisting at the waist
• B. Absence of a dental health provider
• C. Lives in a home with 25 other migrant workers
• D. Report of muscle twitching and skin rash

Correct answer: D

Rationale: The correct answer is D because muscle twitching and a rash could indicate pesticide poisoning, a serious condition that requires immediate attention in a migrant farm worker. Option A is not the priority as it could be musculoskeletal in nature and managed after addressing urgent issues. Option B, absence of a dental health provider, though important for overall health, is not an immediate priority. Option C, living with 25 other migrant workers, raises concerns about living conditions but does not present an immediate health threat compared to potential pesticide poisoning.

2. A nurse is preparing a client for surgery. Which of the following actions should be taken first?

• A. Ensure informed consent is signed
• B. Start IV fluids
• C. Administer preoperative antibiotics
• D. Reinforce surgical site dressing

Correct answer: A

Rationale: The correct answer is to ensure informed consent is signed first when preparing a client for surgery. This step is crucial as it ensures that the client has been informed about the procedure, risks, benefits, and alternatives before giving consent. Starting IV fluids (choice B) may be necessary but comes after obtaining informed consent. Administering preoperative antibiotics (choice C) is important but typically follows confirming informed consent. Reinforcing surgical site dressing (choice D) is a postoperative step and does not take precedence over obtaining informed consent.

3. A nurse suspects a colleague of diverting narcotics. What is the nurse's first course of action?

• A. Confront the colleague directly about the suspicion.
• B. Report the suspicion to the nurse manager.
• C. Ignore the situation unless there is clear evidence.
• D. Keep a record of the colleague's actions for future reference.

Correct answer: B

Rationale: The correct first course of action for a nurse suspecting a colleague of diverting narcotics is to report the suspicion to the nurse manager. Confronting the colleague directly may not be safe and could compromise the investigation. Ignoring the situation is not appropriate as it can pose risks to patient safety. Keeping a record of the colleague's actions is not the primary action to take when drug diversion is suspected; reporting to the nurse manager is crucial for proper investigation and ensuring patient safety.

4. What is the recommended procedure for a healthcare professional to follow when applying sterile gloves?

• A. Use non-sterile gloves first, followed by sterile gloves.
• B. Put on sterile gloves, then gown.
• C. Apply gloves after donning a mask.
• D. Apply gloves before touching any sterile equipment.

Correct answer: D

Rationale: The correct procedure for applying sterile gloves is to do so before touching any sterile equipment or surfaces. This helps maintain the sterility of the gloves. Choices A, B, and C are incorrect because they suggest incorrect sequences that may compromise the sterility of the gloves. Using non-sterile gloves first can introduce contamination, putting on gloves before a gown can lead to contamination of the gloves during gowning, and applying gloves after donning a mask can risk contamination of the gloves from the mask.

5. A nurse observes a colleague not using proper hand hygiene. What should the nurse do first?

• A. Ignore the behavior and continue with care
• B. Discuss the behavior with other colleagues
• C. Confront the colleague about the behavior
• D. Report the behavior to the supervisor

Correct answer: D

Rationale: The correct action for the nurse to take first is to report the behavior to the supervisor. Proper hand hygiene is essential in preventing the spread of infections in healthcare settings. By reporting the observed behavior to the supervisor, the nurse is prioritizing patient safety and promoting a culture of accountability. Ignoring the behavior (Choice A) can put patients at risk, discussing it with other colleagues (Choice B) may not address the issue effectively, and confronting the colleague directly (Choice C) might not be the most appropriate initial step and could lead to conflicts rather than a constructive resolution.

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