Nursing Elites

1. After Brandon is stabilized following his second myocardial infarction due to cocaine use, what collaborative process should begin to connect him with additional resources?

• A. Law enforcement for further prevention
• B. Social services for rehab
• C. Narcotics Anonymous
• D. Financial counselor to apply for assistance

Correct answer: B

Rationale: Following stabilization, it is essential to connect Brandon with additional resources to address his addiction. Social services are a crucial collaborative partner in this situation because they have access to community resources that can support Brandon's rehabilitation needs. While law enforcement may be involved in certain situations, their primary role is not to provide rehabilitation services. Narcotics Anonymous is a valuable support group but does not offer the comprehensive services that social services for rehab can provide. A financial counselor may be beneficial for addressing financial concerns, but the priority at this stage is to address Brandon's addiction through appropriate rehabilitation services.

2. A client is refusing to undergo any more treatments in the hospital and wants to leave against medical advice. When the nurse requests the client to sign an AMA order, the client refuses and leaves. What is the next action of the nurse?

• A. Call security to hold the client until he signs the order
• B. Notify the physician to convince the client to stay
• C. Speak with the client's spouse to persuade him to stay
• D. Allow the client to leave and document the refusal in his chart

Correct answer: D

Rationale: The nurse cannot force the client to stay in the hospital to receive treatment or to sign an AMA order. It is essential to respect the client's autonomy and decision-making capacity. While involving security or pressuring the client through the physician or spouse may seem like options, they are not appropriate in this situation. The nurse should allow the client to leave if they are competent to make that decision, document the refusal in the client's chart to ensure all actions are appropriately documented, and follow institutional policies for patients leaving against medical advice.

3. A patient diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Treatment most likely provided by the center includes

• A. Medical management of symptoms
• B. Daily psychotherapy
• C. Constant staff supervision
• D. Psychological stabilization

Correct answer: A

Rationale: Community mental health centers focus on rehabilitation, vocational needs, education, and socialization, as well as on the management of symptoms and medication. For a patient with a mild anxiety disorder, the primary focus would be on providing medical management of symptoms, such as prescribing appropriate medications and monitoring their effectiveness. Daily psychotherapy is not typically provided in community mental health centers for mild cases, as it may not be necessary. Constant staff supervision and psychological stabilization are more suited for patients requiring a higher level of care or in acute settings where continuous monitoring and stabilization are essential.

4. During a health history assessment of a new patient, which data should be the focus for patient teaching?

• A. Age and gender
• B. Saturated fat intake
• C. Hispanic/Latino ethnicity
• D. Family history of diabetes

Correct answer: B

Rationale: The correct answer is saturated fat intake. Behaviors play a crucial role in health outcomes, and saturated fat intake is a modifiable behavior that can significantly impact a patient's health. By focusing on educating the patient about reducing saturated fat intake, the healthcare provider can empower the patient to make positive changes. While age, gender, ethnicity, and family history are important factors in understanding a patient's health status, they are not behaviors that can be directly modified through patient teaching. Therefore, these factors are essential for developing an individualized care plan but are not the primary focus of patient teaching. Saturated fat intake directly relates to dietary habits, which can be altered through education and support to promote better health outcomes.

5. Mr. W has orders for a physical therapy consult. The nurse contacts the appropriate department but 12 hours later, no one has come to see the client. Which is the most appropriate action of the nurse?

• A. Call the supervisor and file a complaint against the physical therapy department
• B. Contact the physician to notify him that the orders were not carried out
• C. Assess the client's activity level by assisting with ambulation using a gait belt
• D. Contact the physical therapy department again and repeat the order

Correct answer: D

Rationale: In this situation, the most appropriate action for the nurse to take is to contact the physical therapy department again and repeat the order. It is crucial to ensure that the client receives the necessary care as prescribed. Following up with the department reinforces the importance of the order and increases the likelihood of prompt action. Option A is incorrect because escalating the situation to filing a complaint should be a last resort after all other communication attempts have failed. Option B is not the best course of action as the first step should be to ensure proper communication within the healthcare team. Option C is not the priority in this scenario, as the immediate concern is to address the delay in the physical therapy consult.

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