Nursing Elites

1. An advance directive known as a durable power of attorney involves appointing another person called a(n) _____ to act as the decision maker in the event of the patient's incapacitation.

• A. witness
• B. primary caregiver
• C. health care agent
• D. state proxy

Correct answer: C

Rationale: The correct answer is 'health care agent.' A health care agent is appointed through a durable power of attorney to make medical decisions on behalf of a patient who becomes incapacitated. The term 'witness' (choice A) is incorrect because a witness only observes the signing of the directive and does not make decisions. 'Primary caregiver' (choice B) is also incorrect as they may provide care but are not necessarily legally empowered to make decisions. 'State proxy' (choice D) is not commonly used in the context of advance directives or health care decision making, making it an incorrect choice.

2. Mr. CKK is unconscious and was brought to the E.R. Who among the following can give consent for CKK's operation?

• A. Doctor
• B. Nurse
• C. Next of Kin
• D. The Patient

Correct answer: A

Rationale: In the scenario described, when a patient is unconscious and unable to provide consent, the responsibility usually falls on the physician to make decisions regarding the patient's treatment, including obtaining consent for an operation. While nurses play a crucial role in patient care, they typically do not have the authority to provide consent for a major procedure. The next of kin may be consulted for input, but the ultimate decision-making authority lies with the physician. The patient, being unconscious, is unable to provide consent in this situation.

3. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. What will you do first?

• A. Write an incident report and refer the matter to the nursing director
• B. Keep your findings to yourself
• C. Report the matter to your supervisor
• D. Find out from the endorsement any patient who might have been given narcotics

Correct answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

4. The GAUGE size in ET tubes determines:

• A. The external circumference of the tube
• B. The internal diameter of the tube
• C. The length of the tube
• D. The tube’s volumetric capacity

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

5. Dental hygienists should not encourage patients with eating disorders such as bulimia to brush immediately after vomiting because self-induced vomiting causes erosion of tooth enamel and dentin hypersensitivity.

• A. Both the statement and the reason are correct and related
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: D

Rationale: The corrected question emphasizes that patients with eating disorders like bulimia should not brush immediately after vomiting as it can worsen enamel erosion due to the acidic content in the mouth. The correct answer is D because patients should rinse with water or a fluoride mouthwash instead of brushing to protect their teeth. Choice A is incorrect because encouraging patients to brush after vomiting is not recommended. Choice B is incorrect as the reason provided is valid but not suitable for the action of encouraging brushing. Choice C is incorrect as the reason for not brushing after vomiting is to prevent enamel erosion.

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