Nursing Elites

1. In the context of personality disorders, what is a common characteristic of a client with Borderline Personality Disorder?

• A. A need for admiration and a grandiose view of self-importance
• B. Unlawful actions and lack of empathy
• C. Fear of abandonment and impulsiveness
• D. A disregard for others with manipulative behaviors

Correct answer: C

Rationale: The correct answer is C: Fear of abandonment and impulsiveness. Individuals with Borderline Personality Disorder often exhibit intense fears of abandonment, engage in impulsive behaviors such as self-harm or substance abuse, and struggle with unstable relationships. Choices A, B, and D do not align with the characteristic features commonly associated with Borderline Personality Disorder. A need for admiration and grandiosity (Choice A) is more characteristic of Narcissistic Personality Disorder. Unlawful actions and lack of empathy (Choice B) are more typical of Antisocial Personality Disorder. A disregard for others with manipulative behaviors (Choice D) is often seen in individuals with traits of Histrionic or Antisocial Personality Disorders.

2. Which action by the nurse will help prevent ventilator-associated pneumonia (VAP) in a patient on mechanical ventilation?

• A. Provide oral care every 4 hours.
• B. Reposition the patient every 2 hours.
• C. Suction the patient as needed.
• D. Administer antibiotics as prescribed.

Correct answer: A

Rationale: The correct answer is A. Providing oral care every 4 hours helps prevent ventilator-associated pneumonia by reducing the buildup of bacteria in the mouth that can be aspirated into the lungs. Repositioning the patient every 2 hours is important for preventing pressure ulcers but is not directly related to preventing VAP. Suctioning the patient as needed is essential for maintaining airway patency but does not specifically prevent VAP. Administering antibiotics as prescribed is a treatment for infections but does not prevent VAP.

3. A client has a new prescription for beclomethasone inhaler to use with an albuterol inhaler for asthma maintenance. What should the nurse instruct the client?

• A. Skip doses if breathing improves
• B. Use the albuterol inhaler first
• C. Gargle with water after each use
• D. Store inhaler in the refrigerator

Correct answer: C

Rationale: The correct answer is to instruct the client to gargle with water after each use of the beclomethasone inhaler. Beclomethasone can cause oral thrush, and gargling with water helps prevent this complication. Choice A is incorrect because the client should not skip doses even if breathing improves, as the medications are prescribed for maintenance. Choice B is incorrect as there is no specific instruction to use the albuterol inhaler first in this scenario. Choice D is incorrect because inhalers should not be stored in the refrigerator unless specified by the manufacturer.

4. A nurse is planning preoperative care for a client who will undergo surgery. Which of the following is the priority action by the nurse?

• A. Discuss whether family members will assist with postoperative care
• B. Review the client's current home environment
• C. Identify the client's usual coping mechanisms
• D. Determine what the client knows about the surgery

Correct answer: D

Rationale: In the preoperative phase, determining what the client knows about the surgery is the priority. This action helps address misconceptions, provide necessary information, and ensure the client's understanding and cooperation. Choices A, B, and C are important aspects of preoperative care but assessing the client's knowledge about the surgery takes precedence to alleviate fears, enhance communication, and optimize outcomes.

5. What are the important considerations when administering blood products to a patient?

• A. Ensuring proper documentation of the transfusion
• B. Verifying the patient's identity before administration
• C. Monitoring for allergic reactions or transfusion reactions
• D. Monitoring the patient's vital signs during transfusion

Correct answer: B

Rationale: Verifying the patient's identity before administration is a critical step to ensure that the correct blood product is given to the right patient, thereby preventing transfusion errors. While ensuring proper documentation of the transfusion (choice A) is important for record-keeping, verifying patient identity (choice B) directly addresses the risk of administering blood to the wrong patient. Monitoring for allergic reactions or transfusion reactions (choice C) and monitoring the patient's vital signs during transfusion (choice D) are also essential considerations during blood product administration, but verifying patient identity takes precedence to prevent potentially life-threatening errors.

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