Nursing Elites

1. Mary T. was admitted to a nursing home on May 1st. On July 4th, she was diagnosed with a skin infection. This infection is considered a ________________ infection.

• A. nosocomial
• B. systemic
• C. resident flora
• D. resident aura

Correct answer: A

Rationale: The correct answer is 'nosocomial.' A nosocomial infection is defined as one that is not present upon admission to a healthcare facility but instead occurs during the patient's stay. In this case, since Mary was diagnosed with a skin infection after being admitted to the nursing home, it is considered a nosocomial infection. Nosocomial infections are a significant concern in healthcare settings, and infection control measures are in place to prevent their spread. Choices B, C, and D are incorrect. 'Systemic' refers to a condition affecting the entire body, not specific to a healthcare setting. 'Resident flora' and 'resident aura' are not commonly used terms in healthcare and do not relate to infections acquired in healthcare facilities.

2. Which example best describes a nurse who exhibits moral courage?

• A. A nurse feels angry when a parent refuses important treatment for his child.
• B. A nurse considers seeking help for depression when she feels she cannot meet the needs of her clients in the oncology unit.
• C. A nurse contacts a physician for further orders when he fails to order comfort measures for a client with a terminal illness.
• D. A nurse is frustrated when the laboratory is slow in responding to an order for a stat blood glucose.

Correct answer: C

Rationale: Moral courage involves taking action to do what is right, even when there might be negative consequences. The nurse who contacted a physician for further orders acted as a client advocate to seek help, even though she may have faced consequences such as lost time, decreased productivity, or criticism from the physician. Choices A, B, and D do not directly involve advocating for a client's needs or challenging a situation that goes against ethical standards. Feeling angry, seeking help for personal issues, or being frustrated with work processes do not necessarily demonstrate moral courage in the context of nursing practice.

3. The client is being educated about depression by the nurse. Which statement by the client indicates that the teaching has been effective?

• A. ''All elderly individuals experience depression occasionally.''
• B. ''I'm relieved that I will improve within 2 or 3 days.''
• C. ''I never realized depression could occur without a specific cause.''
• D. ''Reducing stress in my life will alleviate the depression.''

Correct answer: C

Rationale: The correct answer, 'I never realized depression could occur without a specific cause,' demonstrates an understanding that depression can arise without a clear trigger, indicating effective teaching. Choice A is incorrect because not all elderly individuals experience depression, and this statement doesn't show understanding. Choice B is incorrect as it reflects a misconception about the quick resolution of depression. Choice D is incorrect as it oversimplifies the relationship between stress reduction and depression resolution.

4. Select the age group that is coupled with an infectious disease that is most common in this age group.

• A. Infants: High bilirubin
• B. Pre-School and School Age Children: Shingles
• C. Young Adults and Teenagers: Sexually transmitted diseases
• D. The Elderly: Malaria

Correct answer: C

Rationale: Young adults and teenagers are at the highest risk for sexually transmitted diseases due to their sexual activity. High bilirubin is a laboratory finding related to jaundice and not an infectious disease. Shingles is more common in the elderly population, not in pre-school and school-age children. Malaria is not most common in the elderly; it is prevalent in regions with specific mosquito vectors. Therefore, the correct answer is that young adults and teenagers are most commonly associated with sexually transmitted diseases.

5. A client with adrenal insufficiency has a potassium level of 7.2 mEq/L. Which of the following signs or symptoms might the client exhibit with this result?

• A. Peaked T waves on the ECG
• B. Muscle spasms
• C. Constipation
• D. A prominent U wave on the ECG

Correct answer: A

Rationale: A client with hyperkalemia may exhibit peaked T waves on an electrocardiogram. This manifestation is an early sign of high potassium levels, but diagnosis should not be based on this aspect alone. Untreated, hyperkalemia can lead to progressively worsening cardiac instability. Muscle spasms (Choice B) are more commonly associated with hypocalcemia. Constipation (Choice C) is not a typical sign of hyperkalemia. A prominent U wave on the ECG (Choice D) is associated with hypokalemia, not hyperkalemia.

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