Nursing Elites

1. 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.

2. What is the MOST COMMON cause of vaginal bleeding immediately after birth?

• A. Uterine atony
• B. Genital lacerations
• C. Abnormal clotting mechanisms
• D. Endometritis

Correct answer: A

Rationale: Vaginal bleeding immediately after birth is most commonly due to uterine atony. Uterine atony is the failure of the uterine muscle to contract adequately after childbirth, leading to postpartum hemorrhage. This condition is more frequent than genital lacerations, abnormal clotting mechanisms, or endometritis as a cause of immediate postpartum bleeding.

3. Which fluid is used in the management of gastrointestinal tract (GIT) loss and burns?

• A. Ringer's lactate
• B. Normal saline
• C. Dextrose
• D. Blood

Correct answer: A

Rationale: Ringer's lactate is the preferred fluid for managing gastrointestinal tract (GIT) losses and burns due to its balanced electrolyte composition. It helps replace lost fluids and electrolytes, making it an ideal choice for resuscitation in such scenarios. Normal saline is commonly used for volume resuscitation but may not be the best choice for these specific conditions. Dextrose is a source of glucose and is not typically used as the primary fluid for GIT losses and burns. Blood transfusion is indicated for specific situations like severe hemorrhage or anemia but is not the primary fluid for GIT losses and burns.

4. The public health RN is engaging with a teen in his community who is concerned about how he will be able to stay part of his friend group when they are all vaping and your client does not want to take part but does not want to feel awkward. Using motivational interviewing techniques, the RN says to the client, 'I understand this concern. Please tell me more about this and how it feels awkward for you.' The RN's question is an example of:

• A. Moving the teen to find a new friend group.
• B. Addressing the problem of teen awkwardness.
• C. Agreeing that awkwardness is hard.
• D. Using open-ended questioning.

Correct answer: D

Rationale: The RN's question, 'Please tell me more about this and how it feels awkward for you,' is an example of using open-ended questioning. Open-ended questions encourage clients to share more about their feelings and thoughts, allowing for a deeper exploration of their concerns and experiences. It helps in building rapport, understanding the client's perspective, and facilitating a client-centered conversation.

5. All of the following are objectives of FHSIS except:

• A. To complete the clinical picture of chronic diseases and describe their natural history
• B. To provide a standardized, facility-level database that can be accessed for more in-depth studies
• C. To minimize recording and reporting burden, allowing more time for patient care and promotive activities
• D. To ensure that reported data are useful, accurate, and disseminated in a timely and easy-to-use fashion

Correct answer: A

Rationale: The objective of FHSIS is not to complete the clinical picture of chronic diseases and describe their natural history. Instead, it focuses on providing standardized facility-level data, minimizing reporting burden to allow more time for patient care, and ensuring that reported data are useful, accurate, and disseminated effectively.

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