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 nursing student is teaching a patient and family about epilepsy prior to the patient's discharge. For which statement should you intervene?

• A. "You should avoid consumption of all forms of alcohol."?
• B. "Wear your medical alert bracelet at all times."?
• C. "Protect your loved one's airway during a seizure."?
• D. "It's important to consult with your physician before taking over-the-counter medications."?

Correct answer: D

Rationale: The correct answer is, "It's important to consult with your physician before taking over-the-counter medications."? Patients with epilepsy should not take over-the-counter medications without medical advice due to potential interactions with antiepileptic drugs or triggering seizures. Choices A, B, and C are all appropriate statements for a patient with epilepsy, focusing on alcohol avoidance, wearing a medical alert bracelet, and airway protection during a seizure, respectively. Choice D is incorrect because patients with epilepsy need to be cautious about medications due to possible interactions or adverse effects, so consulting with a physician is crucial before taking over-the-counter medications.

3. Which of the following situations warrants a measurement for orthostatic hypotension?

• A. A 36-year-old male with a spinal injury
• B. An 86-year-old female with significantly altered mental status
• C. A 58-year-old female with near-syncope
• D. A 41-year-old male with acute deep vein thrombosis

Correct answer: C

Rationale: The correct answer is a 58-year-old female with near-syncope. Orthostatic hypotension is a drop in blood pressure of greater than 20 mmHg systolic when moving from a sitting or lying position to standing. Patients at higher risk include those with syncope or near-syncope, symptomatic hypovolemia, and those prone to falls. The other choices are less likely to present with orthostatic hypotension. A spinal injury, altered mental status, and acute deep vein thrombosis are not directly associated with the immediate need for orthostatic hypotension measurement.

4. One of the complications of complete bed rest and immobility is which of the following?

• A. Plantar flexion
• B. Dorsiflexion
• C. Extension contractures
• D. Adduction contractures

Correct answer: A

Rationale: Plantar flexion, or foot drop, is a common complication of complete bed rest and immobility. This condition occurs due to the weakening of muscles that lift the foot, leading to the foot dragging or being unable to clear the ground during walking. Dorsiflexion refers to moving the foot upwards, which is not a typical complication of immobility. Extension contractures involve the inability to fully extend a joint, while adduction contractures refer to the inability to move a limb away from the body. These types of contractures can also occur with immobility, but they are not specifically associated with foot drop.

5. OSHA has very strict standards for hospital employees who may encounter hazardous materials or patients who have been exposed to them. These regulations include all of the following EXCEPT:

• A. Respiratory protection must be provided to all employees who might be exposed.
• B. Training on respiratory protection must be provided.
• C. Employers must provide personal protective equipment to all employees.
• D. All ED personnel must be trained in decontamination procedures.

Correct answer: D

Rationale: OSHA regulations for hospital employees dealing with hazardous materials or exposed patients require respiratory protection for potentially exposed employees, training on respiratory protection, and the provision of personal protective equipment. However, not all ED personnel are required to be trained in decontamination procedures. While all ED staff should have a basic understanding of hazmat situations, specific training in decontamination procedures is only necessary for those who will be directly involved in the decontamination process. Therefore, the correct answer is that all ED personnel must be trained in decontamination procedures, as this is not a mandatory requirement under OSHA regulations for hospital employees who may encounter hazardous materials or exposed patients.

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