Nursing Elites

1. An occupational health nurse in a factory is planning interventions to reduce environmental stressors for employees. Which of the following interventions should the nurse use to affect physical agents in the environment?

• A. Teach workers to choose personal strategies to cope with work stress
• B. Limit the amount of time workers spend in temperatures over 43.3°C (110°F)
• C. Provide ear plugs for use at workstations throughout the factory
• D. Obtain dosimeters for employees to wear when using new machinery that emits radiation

Correct answer: B

Rationale: Limiting exposure to extreme temperatures is important to protect workers from heat-related illnesses.

2. Which of the following actions is a means of maintaining medical asepsis to reduce and prevent the spread of microorganisms?

• A. Sterilizing contaminated items
• B. Routinely cleaning the hospital environment
• C. Reapplying a sterile dressing
• D. Applying a sterile gown and gloves

Correct answer: A

Rationale: The correct answer is A: Sterilizing contaminated items. Maintaining medical asepsis involves ensuring that items are free of microorganisms to prevent infections. Sterilizing contaminated items is a crucial step in this process as it eliminates all microorganisms, including spores. Choices B, C, and D do not directly address the process of reducing and preventing the spread of microorganisms. While routinely cleaning the hospital environment is important for cleanliness, it does not guarantee the elimination of all microorganisms. Reapplying a sterile dressing and applying a sterile gown and gloves are specific actions related to personal protective equipment and wound care, not the general maintenance of medical asepsis.

3. A nurse is planning care for a client who has dehydration and is receiving a continuous IV infusion of 0.9% sodium chloride. Which of the following interventions should the nurse include in the plan of care?

• A. Monitor the client's intake and output every 6 hours
• B. Administer furosemide to the client
• C. Check the client's IV infusion every 8 hours
• D. Offer the client 240 ml (8 oz) of oral fluids every 4 hours

Correct answer: D

Rationale: Offering the client 240 ml (8 oz) of oral fluids every 4 hours is essential to maintain hydration in a client with dehydration who is receiving continuous IV infusion. This intervention helps ensure an adequate fluid balance. Monitoring the client's intake and output every 6 hours is necessary to assess hydration status and response to treatment. Administering furosemide to the client, choice B, is contraindicated in dehydration as it can further deplete fluid volume. Checking the IV infusion every 8 hours, as in choice C, is important but not as critical as ensuring oral fluid intake to promote hydration.

4. What are the common side effects of opioid analgesics, and how should they be managed?

• A. Drowsiness and dizziness, ensuring safety precautions
• B. Respiratory depression, ensuring adequate ventilation
• C. Constipation and nausea, managed with stool softeners
• D. Nausea and vomiting, managing with antiemetics

Correct answer: A

Rationale: The correct answer is A. Common side effects of opioid analgesics include drowsiness and dizziness. These side effects can impair a person's ability to operate machinery or drive safely. To manage these side effects, it is essential to advise patients to avoid activities that require alertness until they know how the medication affects them. Choices B, C, and D are incorrect because respiratory depression, constipation, and nausea are also common side effects of opioids, but they are not the primary side effects being asked for in this question.

5. What is the most appropriate method for preventing catheter-associated urinary tract infections (CAUTIs)?

• A. Insert a urinary catheter using clean gloves.
• B. Limit the duration of catheter use.
• C. Use a smaller size catheter to prevent trauma.
• D. Change the catheter tubing every 24 hours.

Correct answer: B

Rationale: The correct answer is B: Limit the duration of catheter use. Limiting the duration of catheterization is a crucial method for preventing catheter-associated urinary tract infections (CAUTIs). Prolonged catheter use increases the risk of introducing pathogens into the urinary tract, leading to infections. Using clean gloves for insertion (choice A) is important for preventing contamination but does not address the main cause of CAUTIs. Using a smaller size catheter (choice C) may help reduce trauma but does not directly prevent infections. Changing the catheter tubing every 24 hours (choice D) is not necessary unless clinically indicated, and it is not the most effective method for preventing CAUTIs.

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