Nursing Elites

1. Sinusitis is caused by:

• A. Bacteria
• B. Fungus
• C. Virus
• D. Any of the above

Correct answer: D

Rationale: Sinusitis can be caused by bacteria, viruses, or fungi. While bacterial infections are the most common cause, viral or fungal infections can also lead to sinusitis. Therefore, the correct answer is 'Any of the above.' Choices A, B, and C are incorrect because they only represent individual causes of sinusitis, whereas choice D encompasses all possible causes.

2. While caring for a client who has just come from surgery and is in the recovery room with an endotracheal tube in place, the nurse deflates the cuff on the tube and removes it. The client sits up in bed, grasps his throat, and begins to make wheezing sounds. Which of the following conditions is the most likely cause of this situation?

• A. The client is choking on part of the tube
• B. The client has anxiety
• C. The client is having a laryngospasm
• D. The client is having a normal response from anesthesia

Correct answer: D

Rationale: After surgery, some clients may experience a laryngospasm during emergence from anesthesia. A laryngospasm can lead to the closure of the laryngeal opening due to spasm of the vocal cords. In this scenario, the client's symptoms of wheezing and throat grasping are indicative of a laryngospasm rather than choking on the tube, anxiety, or a normal response from anesthesia. The nurse should act promptly to open the airway to aid breathing and consider administering muscle relaxants as necessary.

3. Choose the BEST answer. To ensure adequate protection for legal issues, offices should maintain patients' charts for:

• A. 10 years
• B. Forever
• C. Until the age of majority
• D. 2 years after the patient was last seen in the office

Correct answer: B

Rationale: The correct answer is 'Forever.' Maintaining patients' charts indefinitely ensures comprehensive legal protection by having all relevant information available in case of litigation or if patient history needs to be referenced in the future. Choice A, '10 years,' may not be sufficient to cover the entire period within which legal issues may arise. Choice C, 'Until the age of majority,' is not ideal as legal matters may extend beyond this age limit. Choice D, '2 years after the patient was last seen in the office,' is inadequate as legal actions can occur beyond this timeframe, necessitating the need for long-term retention of patient charts.

4. Which of the following interventions should be prioritized in the care of the suicidal client?

• A. Remove all potentially harmful items from the client's room
• B. Allow the client to express feelings of hopelessness
• C. Note the client's capabilities to increase self esteem
• D. Set a "no suicide"? contract with the client

Correct answer: A

Rationale: accessibility of the means of suicide increases the lethality. Allowing a patient to express feelings and setting a no suicide contract are interventions for suicidal client but blocking the means of suicide is priority. Increasing self esteem is an intervention for depressed clients but not specifically for suicide.

5. Which of the following statements best describes compartment syndrome?

• A. An injury causes pain and tingling that starts in the buttock and travels down the leg.
• B. An injury causes swelling within muscle tissue that leads to anoxia of nerves and muscles.
• C. An injury causes permanent flexion of the interphalangeal joint, resulting in deformity.
• D. An injury causes pain and swelling of the median plantar nerve.

Correct answer: B

Rationale: Compartment syndrome is characterized by swelling and increased pressure within a muscle compartment, leading to decreased blood flow and oxygen supply to nerves and muscles. This can result from various causes, such as trauma or the application of a cast after a fracture. If left untreated, compartment syndrome can lead to tissue necrosis. Choice A is incorrect as pain and tingling starting in the buttock and traveling down the leg are not specific features of compartment syndrome. Choice C is incorrect as permanent flexion of the interphalangeal joint is unrelated to compartment syndrome. Choice D is incorrect as pain and swelling of the median plantar nerve do not describe compartment syndrome.

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