Nursing Elites

1. A patient who has multiple health issues is discharged after a recent hospitalization. Which of the following comprehensive programs would a community health nurse refer the patient to if the patient is not under medical supervision but does have insurance?

• A. private health care practitioner
• B. a patient-centered medical home
• C. hospital clinic
• D. subacute facility

Correct answer: B

Rationale: A patient-centered medical home is a comprehensive care model that provides coordinated healthcare services across various settings. It is an ideal referral for a patient with multiple health issues who is not under medical supervision but has insurance, as it offers a patient-focused approach to managing the patient's overall health needs.

2. Donna needs further teaching about the use of partograph if she said to her CI that:

• A. I will start using the partograph if the patient's cervix is already 4 cm dilated.
• B. I can use the partograph in all pregnant women.
• C. I will plot the cervical dilatation using 'x'.
• D. I need to refer my patient to the hospital if the cervical dilatation reaches the action line.

Correct answer: B

Rationale: Donna needs further teaching because using a partograph in all pregnant women is incorrect. The partograph is specifically used when labor is established to monitor the progress of labor and identify deviations from normal patterns. It is not meant to be used indiscriminately in all pregnant women, but rather in those who are in labor to enhance safe delivery practices.

3. Which statement is incorrect regarding an informed consent signed by a patient?

• A. The nurse is responsible for obtaining the consent for surgery
• B. Patients under 18 years of age may need a parent or legal guardian to sign a consent form
• C. The nurse can witness the client signing the consent form
• D. It is the nurse's responsibility to ensure the patient has been educated by the physician about the procedure before informed consent is obtained

Correct answer: A

Rationale: The statement 'The nurse is responsible for obtaining the consent for surgery' is incorrect. The responsibility of obtaining informed consent for surgery lies with the physician or surgeon performing the procedure. Nurses can assist in the process by witnessing the client signing the consent form, ensuring the patient is educated about the procedure by the physician, and verifying that the consent process is voluntary and informed. For patients under 18 years of age, a parent or legal guardian typically needs to sign the consent form on behalf of the minor, as they are not legally able to provide consent themselves.

4. After surgery, your patient starts to shiver uncontrollably. What nursing intervention would you do first?

• A. Apply warm blankets & continue oxygen as prescribed
• B. Take the patient's rectal temperature
• C. Page the doctor for further orders
• D. Adjust the thermostat in the room

Correct answer: A

Rationale: When a patient starts shivering uncontrollably after surgery, the priority nursing intervention is to apply warm blankets and continue oxygen as prescribed. Shivering can be a sign of hypothermia, and maintaining the patient's body temperature is crucial for their recovery. This intervention helps prevent further heat loss and supports the patient's comfort and safety. While monitoring temperature, paging the doctor, and adjusting the room temperature may be necessary, addressing the immediate need for warmth and oxygen is the priority in this situation.

5. Match the following terms in column A with the correct definition in Column B:

• A. I. Topical anesthesia C. The agent is applied directly to the skin and mucous membranes of the skin. II. Epidural anesthesia D. Injecting the anesthesia in the epidural mater of the spinal cord.
• B. II. Epidural anesthesia B. Anesthesia is introduced in the subarachnoid space at the lumbar area L4 and L5. I. Topical anesthesia C. The agent is applied directly to the skin and mucous membranes of the skin.
• C. I. Topical anesthesia C. The agent is applied directly to the skin and mucous membranes of the skin. II. Epidural anesthesia D. Injecting the anesthesia in the epidural mater of the spinal cord.
• D. I. Topical anesthesia C. The agent is applied directly to the skin and mucous membranes of the skin. II. Epidural anesthesia B. Anesthesia is introduced in the subarachnoid space at the lumbar area L4 and L5.

Correct answer: A

Rationale: Topical anesthesia involves applying the anesthetic agent directly to the skin and mucous membranes to numb the area. On the other hand, epidural anesthesia involves injecting the anesthetic into the epidural space surrounding the spinal cord. Therefore, the correct matches are: I. Topical anesthesia with the definition of applying the agent directly to the skin and mucous membranes (Choice C), and II. Epidural anesthesia with the definition of injecting the anesthesia in the epidural space around the spinal cord (Choice D).

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