Nursing Elites

1. An assisted living facility is an example of which type of healthcare provider?

• A. Primary care
• B. Secondary care
• C. Tertiary care
• D. None of the above

Correct answer: C

Rationale: An assisted living facility is an example of a tertiary care provider. Tertiary care providers offer specialized services such as rehabilitation, long-term care, and management of complex medical conditions. These services are typically provided after primary and secondary care interventions. Choice A, primary care, focuses on preventive care and routine medical treatment for common illnesses, which is not the level of care provided by assisted living facilities. Choice B, secondary care, involves specialized medical services provided by medical specialists and hospitals for conditions that require a higher level of expertise than primary care, but it is not the level of care provided by assisted living facilities. Choice D, None of the above, is incorrect as assisted living facilities fall under the category of tertiary care providers.

2. Which example best describes a nurse who exhibits moral courage?

• A. A nurse feels angry when a parent refuses important treatment for his child.
• B. A nurse considers seeking help for depression when she feels she cannot meet the needs of her clients in the oncology unit.
• C. A nurse contacts a physician for further orders when he fails to order comfort measures for a client with a terminal illness.
• D. A nurse is frustrated when the laboratory is slow in responding to an order for a stat blood glucose.

Correct answer: C

Rationale: Moral courage involves taking action to do what is right, even when there might be negative consequences. The nurse who contacted a physician for further orders acted as a client advocate to seek help, even though she may have faced consequences such as lost time, decreased productivity, or criticism from the physician. Choices A, B, and D do not directly involve advocating for a client's needs or challenging a situation that goes against ethical standards. Feeling angry, seeking help for personal issues, or being frustrated with work processes do not necessarily demonstrate moral courage in the context of nursing practice.

3. Which information given by a 70-year-old patient during a health history indicates to the nurse that the patient should be screened for hepatitis C?

• A. The patient had a blood transfusion in 2005
• B. The patient used IV drugs about 20 years ago
• C. The patient frequently eats in fast-food restaurants
• D. The patient traveled to a country with poor sanitation

Correct answer: B

Rationale: The correct answer is 'The patient used IV drugs about 20 years ago.' Any patient with a history of IV drug use should be tested for hepatitis C due to the increased risk of transmission through sharing needles. Blood transfusions given after 1992, when an antibody test for hepatitis C became available, do not pose a risk for hepatitis C. Hepatitis C is not spread by the oral-fecal route, so contaminated food or traveling to countries with poor sanitation are not direct risk factors for hepatitis C.

4. A woman presents with bruises on her face and back in various stages of healing. She states, 'sometimes he just gets so angry.' Which of the following statements is most appropriate as a response from the nurse?

• A. Do you mean your boyfriend?
• B. Do you mean your boyfriend?
• C. No one will ever hurt you again.
• D. Tell me more about what happens when he gets angry.

Correct answer: D

Rationale: The most appropriate response from the nurse is to gather more information by asking the client to elaborate on what occurs when the individual in question gets angry. It is essential for the nurse to understand the situation better before taking any action or making assumptions. Option A and B are repetitive and do not encourage further exploration of the situation. Option C offers a false promise and reassurance that the nurse cannot guarantee, which may not be helpful in addressing the client's needs.

5. Tommy R., your 68-year-old patient, is at risk for falls. He has fallen 3 times in the last month. You should keep Tommy's ______________ in order to prevent him from falling again.

• A. bedside rails up at all times
• B. bed in the low position
• C. call bell within reach
• D. family members in the room at all times

Correct answer: C

Rationale: To prevent falls, it is essential to keep the patient's call bell within reach so they can easily call for help when needed. This allows for timely assistance and can prevent falls. While low beds can reduce the severity of injuries in case of a fall, they do not prevent falls from happening. Having family members in the room at all times is not a realistic or practical solution. Side rails can actually increase the severity of falls as patients may attempt to climb over them, and using side rails as fall prevention is considered a restraint practice that can lead to entrapment and other risks.

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