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. A nurse manager notices a discrepancy in a nurse's narcotics record. What is the appropriate action?

• A. Ask the nurse for clarification about the record.
• B. Report the discrepancy to the pharmacy.
• C. Report the issue to the nurse manager immediately.
• D. Ignore the discrepancy as a clerical error.

Correct answer: B

Rationale: The appropriate action when a nurse manager notices a discrepancy in a nurse's narcotics record is to report the discrepancy to the pharmacy. Reporting such discrepancies is crucial to ensure accountability and patient safety. Choice A is incorrect because the nurse manager should not confront the nurse directly without proper investigation. Choice C is incorrect because reporting to the nurse manager may not address the issue effectively. Choice D is incorrect because ignoring the discrepancy can compromise patient safety and violates protocols.

3. A nurse is assessing a client who is being admitted from the PACU following an abdominal hysterectomy. Which of the following assessments is the nurse's priority?

• A. Urinary output
• B. Pain level
• C. Oxygen saturation
• D. Abdominal dressing

Correct answer: C

Rationale: The correct answer is C: Oxygen saturation. Following abdominal surgery, the priority assessment is to ensure adequate oxygenation. Monitoring oxygen saturation is crucial as the client may be at risk of respiratory complications due to the effects of anesthesia, pain medications, and the surgical procedure itself. Assessing urinary output is important for monitoring kidney function but is not the priority immediately postoperatively. Pain level assessment is essential for the client's comfort but does not take precedence over ensuring oxygen saturation. Checking the abdominal dressing is important for wound assessment, but ensuring adequate oxygenation is the priority in the immediate postoperative period.

4. While reviewing notes from a previous shift, a nurse finds incomplete documentation. What is the most appropriate action?

• A. Complete the missing documentation
• B. Notify the nurse manager of the issue
• C. Ask the nurse to complete the documentation
• D. Confront the nurse about the incomplete notes

Correct answer: B

Rationale: The most appropriate action when finding incomplete documentation is to notify the nurse manager of the issue. This ensures that accurate records are maintained and the situation can be addressed properly. Completing the missing documentation on behalf of someone else may lead to inaccuracies, asking the nurse to complete it may not guarantee timely correction, and confronting the nurse could create a confrontational situation that is not conducive to effective teamwork.

5. When considering a bone marrow transplant for a client with leukemia, which ethical principle pertains to minimizing harm to the client?

• A. Justice
• B. Nonmaleficence
• C. Autonomy
• D. Beneficence

Correct answer: B

Rationale: The correct answer is B: Nonmaleficence. Nonmaleficence is the ethical principle that emphasizes the obligation to do no harm, making it crucial in medical decision-making. In the context of a bone marrow transplant for a client with leukemia, the primary concern is to minimize harm and avoid causing any unnecessary suffering or adverse effects. Choices A, C, and D are incorrect: Justice relates to fairness in resource allocation and treatment decisions, Autonomy involves respecting the patient's right to make decisions about their own care, and Beneficence refers to the obligation to act in the patient's best interest and promote their well-being, which may involve some level of risk or harm for overall benefit.

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