Nursing Elites

1. How many feet should separate the nurse and the source when extinguishing a small, wastebasket fire with an appropriate extinguisher?

• A. 1 foot
• B. 2 feet
• C. 4 feet
• D. 6 feet

Correct answer: D

Rationale: The nurse should stand about 6 feet from the source of the fire. Getting closer might put the nurse in danger. Choice A, 1 foot, is incorrect because it is too close to the fire and can expose the nurse to unnecessary risk. Choice B, 2 feet, is also too close to the fire and may lead to potential harm. Similarly, choice C, 4 feet, is not the ideal distance as it is still within the range of potential danger. The correct answer is D, 6 feet, which is a safe distance for the nurse to extinguish the fire effectively without risking personal safety.

2. A nurse planning care for her assigned clients understands that which aspect is the purpose of the hospital's standards of care?

• A. Identify methods of treatment.
• B. Provide direction for care based on the client's diagnosis.
• C. Identify new care methods based on current medical research.
• D. Provide direction for the practice of nursing

Correct answer: D

Rationale: The purpose of the hospital's standards of care is to provide a broad direction for the overall practice of nursing that applies to all nursing situations, across specialty areas, and across the country. These standards guide the practice of nursing by outlining the expected level of care and professional performance. While identifying methods of treatment is important, it is usually specific to individual client needs and not the overarching goal of standards of care. Providing direction for care solely based on the client's diagnosis is limited to a particular patient's treatment plan and does not encompass the broader scope of nursing practice. Identifying new care methods based on current medical research is essential for advancing healthcare practices but is not the primary purpose of the hospital's standards of care.

3. The nurse and a colleague are on the elevator after their shift, and they hear a group of healthcare providers discussing a recent client scenario. Which client right might be breached?

• A. right to refuse treatment
• B. right to continuity of care
• C. right to confidentiality
• D. right to reasonable responses to requests

Correct answer: C

Rationale: The right to confidentiality of client information might be breached when client care situations are discussed in public areas or without regard to maintaining the information as private and confidential. In this scenario, the conversation on the elevator could lead to a breach of the client's right to confidentiality. The other options, such as the right to refuse treatment, right to continuity of care, and right to reasonable responses to requests, are not being breached in this instance, making them incorrect choices.

4. What are the hazards of improper splinting?

• A. Aggravation of a bone or joint injury
• B. Reduced distal circulation
• C. Delay in transporting a client with a life-threatening injury
• D. All of the above

Correct answer: D

Rationale: Hazards of improper splinting can lead to the aggravation of a bone or joint injury, reduced distal circulation, and delay in transporting a client with a life-threatening injury. Choosing 'All of the above' (Option D) is the correct answer as it encompasses all the hazards mentioned. Option A is incorrect because it only addresses one aspect of the hazards. Option B is incorrect as it does not cover all the hazards associated with improper splinting. Option C is incorrect as it focuses on only one hazard and does not account for the others.

5. While working the 11 p.m. to 7 a.m. shift at the long-term care unit, the nurse gathers the nursing staff to listen to the 3 to 11 p.m. intershift report. The nurse notes that a staff member has an odor of alcohol on her breath, slurred speech, and an unsteady gait, suspecting alcohol intoxication. What is the most appropriate action for the nurse to take?

• A. Contact the nursing supervisor.
• B. Tell the staff member that she is not allowed to administer medications.
• C. Ask the staff member how much alcohol she has consumed.
• D. Ask the staff member to rest in the nurses' lounge until the effects of the alcohol wear off.

Correct answer: A

Rationale: When a staff member reports to work showing signs of alcohol intoxication, the nurse should objectively note the symptoms and ask a second person to confirm these observations. It is crucial to contact the nursing supervisor immediately. An odor of alcohol, slurred speech, unsteady gait, and errors in judgment are indicators of intoxication, posing a risk to client safety. The staff member should be removed from the client care area. Detailed documentation of the incident is essential, including observations, actions taken, future plans, and the staff member's signature and date on the recorded incident memo. If the staff member refuses to sign, this should be noted by the nurse and a witness. Asking the staff member to rest in the nurses' lounge or restricting medication administration does not ensure client safety, as the staff member could still jeopardize it. Inquiring about the amount of alcohol consumed is confrontational and not relevant to the immediate need of ensuring safety.

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