Nursing Elites

1. A patient works with a nurse to establish outcomes. The nurse believes that one outcome suggested by the patient is not in the patient's best interest. What is the nurse's best action?

• A. Remain silent.
• B. Educate the patient that the outcome is not realistic.
• C. Explore with the patient possible consequences of the outcome.
• D. Formulate an appropriate outcome without the patient's input.

Correct answer: C

Rationale: In this scenario, the nurse should collaborate with the patient rather than impose personal opinions. While the nurse should respect the patient's autonomy, they also have a duty to provide guidance. By exploring possible consequences of the suggested outcome with the patient, the nurse can facilitate a discussion that helps the patient make an informed decision. This approach respects the patient's input while ensuring their well-being. Remaining silent (Choice A) may not address the issue, educating the patient unilaterally (Choice B) may be perceived as dismissive, and formulating an outcome without patient input (Choice D) disregards the patient's autonomy and preferences.

2. Which of the following medical terms means 'surgical fixation of the stomach'?

• A. Abdominorrhaphy
• B. Gastroplasty
• C. Gastropexy
• D. Abdominorrhexis

Correct answer: C

Rationale: The correct answer is 'Gastropexy,' which means 'surgical fixation of the stomach.' This procedure involves surgically fixing the stomach in place. 'Abdominorrhaphy' refers to suturing or repairing the abdomen, not related to fixing the stomach. 'Gastroplasty' is a surgical reconstruction of the abdomen, not specifically related to fixing the stomach. 'Abdominorrhexis' refers to the rupture or tearing of the abdomen, not a surgical fixation procedure.

3. A nurse caring for a client diagnosed with pertussis is ordered to maintain droplet precautions. Which of the following actions of the nurse upholds droplet precautions?

• A. Assign the client to stay in a negative-pressure room
• B. Use sterilized equipment when sharing between this client and another person with pertussis
• C. Wear a mask if coming within 3 feet of the client
• D. Both A and C

Correct answer: C

Rationale: When caring for a client requiring droplet precautions, it is essential for the nurse to wear a mask when within 3 feet of the client. This practice helps prevent the transmission of droplet particles that may be produced when the client coughs or sneezes. Assigning the client to a negative-pressure room is not typically necessary for droplet precautions unless specifically indicated for airborne precautions. Using sterilized equipment when sharing between clients with pertussis is important for infection control but does not directly relate to droplet precautions. Therefore, the correct action to uphold droplet precautions in this scenario is to wear a mask when coming within close proximity to the client.

4. Which bloodborne pathogen is the most virulent? (Choose the BEST answer.)

• A. HCV
• B. HPV
• C. HIV
• D. HBV

Correct answer: A

Rationale: The correct answer is HCV (Hepatitis C Virus). Hepatitis C is considered the most virulent bloodborne pathogen, being 100 times more virulent than Hepatitis B. HPV (Human Papillomavirus) is a sexually transmitted infection but is not a bloodborne pathogen. HIV (Human Immunodeficiency Virus) affects the immune system but is not as virulent as Hepatitis C in terms of bloodborne transmission. HBV (Hepatitis B Virus) is less virulent compared to HCV in the context of bloodborne transmission.

5. A healthcare professional is preparing to administer an enteral feeding through a gastrostomy tube. Before administering the feeding, the healthcare professional aspirates some stomach contents and checks the pH. The result is 3.9. What is the next action of the healthcare professional?

• A. Administer the feeding as ordered
• B. Pull the feeding tube out approximately 3 cm
• C. Flush the feeding tube with 60 cc of water
• D. Contact the physician

Correct answer: A

Rationale: When the pH of the aspirated stomach contents is 4 or less, it indicates that the gastrostomy tube is in the stomach, confirming correct placement. A pH of 3.9 falls within this range, so the healthcare professional can proceed with administering the enteral feeding. There is no need to adjust the tube placement, flush with water, or contact the physician in this situation as the tube is appropriately positioned for feeding.

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