Nursing Elites

1. Distribution of a drug to various tissues depends on the amount of cardiac output to each type of tissue. Which tissue would receive the highest amount of cardiac output and thus the highest amount of a drug?

• A. skin
• B. adipose tissue
• C. skeletal muscle
• D. myocardium

Correct answer: D

Rationale: The correct answer is 'myocardium.' Highly perfused tissues include vital organs like the brain, heart, kidneys, adrenal glands, and liver. The myocardium, being heart muscle, receives the highest amount of cardiac output and thus the highest amount of a drug. Choices A, B, and C are incorrect because the skin and adipose tissue are poorly perfused, while skeletal muscle is less perfused compared to vital organs like the myocardium.

2. A nursing assistant who has been employed in the long-term care center for 8 weeks is consistently taking extended lunch breaks. The nursing assistant's behavior has caused problems with client care during lunch hours. What is the appropriate way for the nurse to deal with this situation?

• A. Ignoring the situation
• B. Documenting the problem in the nursing assistant's personnel file
• C. Asking other staff members to cover for the nursing assistant
• D. Meeting with the nursing assistant to discuss the behavior and initiate problem-solving measures

Correct answer: D

Rationale: Taking extended lunch breaks is an unacceptable behavior, especially when it affects client care. The appropriate way for the nurse to deal with this situation is to meet with the nursing assistant to discuss the behavior and initiate problem-solving measures. This direct approach allows for open communication and the opportunity to address the issue effectively. Ignoring the situation (Choice A), asking other staff members to cover (Choice C), or documenting the problem in the nursing assistant's personnel file (Choice B) are not effective solutions. Ignoring the behavior does not address the issue, asking others to cover may not solve the problem at its root, and documenting the problem should come after attempting to resolve the issue through communication and problem-solving first.

3. When evaluating the lab work of a client in hepatic coma, which of the following lab tests is most important?

• A. blood urea nitrogen
• B. serum calcium
• C. serum ammonia
• D. serum creatinine

Correct answer: C

Rationale: When a client is in hepatic coma due to liver failure, the liver cannot metabolize amino acids completely, leading to elevated ammonia levels. Increased ammonia can cause brain-tissue irritation, worsening the coma. Therefore, monitoring serum ammonia levels is crucial in assessing the severity of hepatic coma. Choices A, B, and D are less relevant in the context of hepatic coma. Blood urea nitrogen primarily assesses kidney function, serum calcium levels are not directly related to hepatic coma, and serum creatinine is more indicative of kidney function rather than liver function in this scenario.

4. What is the role of an incident report in risk management?

• A. To provide liability protection.
• B. To provide data for analysis by a risk manager to determine how future problems can be avoided.
• C. To discipline staff for errors.
• D. All of the above.

Correct answer: B

Rationale: The correct answer is B. Incident reports play a crucial role in risk management by providing data for analysis to prevent future problems. They are not primarily for liability protection (A) or disciplining staff (C). Therefore, choice B is the most appropriate answer. Choosing option D is incorrect because incident reports do not solely exist for all the mentioned purposes, but primarily to provide data for analysis and preventive actions.

5. The nurse acts as an advocate for the nursing profession by performing all of the following activities except:

• A. encouraging political involvement by nurses with their legislators.
• B. acting as a first-aid provider for a children's athletic team.
• C. precepting newly licensed nurses in the work situation.
• D. encouraging as many persons to become nurses as possible.

Correct answer: D

Rationale: The nurse acts as an advocate for the nursing profession by encouraging appropriate persons to become nurses, by being a positive role model and mentor, and by communicating the needs of nurses in the most professional manner possible to those making the laws. Encouraging as many persons as possible to become nurses may not align with the advocacy role, as the focus should be on quality rather than quantity. Choices A, B, and C are activities that align with being an advocate for the nursing profession by promoting political involvement, providing first aid, and precepting newly licensed nurses, respectively.

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