Nursing Elites

1. The client has a do-not-resuscitate (DNR) order. The family asks the nurse to ignore the DNR if the client codes. What is the nurse's responsibility?

• A. Follow the family's wishes
• B. Explain that the DNR must be honored
• C. Ignore the DNR and proceed with CPR
• D. Perform CPR if the client codes

Correct answer: B

Rationale: The correct answer is B: 'Explain that the DNR must be honored.' The nurse's responsibility is to follow the DNR order, as it is a legal and ethical obligation. Choice A is incorrect because following the family's wishes would go against the established DNR order. Choice C is incorrect as ignoring the DNR order is not appropriate. Choice D is also incorrect as performing CPR would be contrary to the client's expressed wishes in the DNR order.

2. A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse take?

• A. Wear gloves only
• B. Wear a mask
• C. Wash hands before and after client care
• D. Use an N95 respirator

Correct answer: C

Rationale: The correct precaution for a nurse caring for a client with shigella-induced diarrhea is to wash hands before and after client care. Shigella is a highly contagious bacterium that spreads through contaminated food, water, or contact with infected individuals. While wearing gloves is important when directly handling bodily fluids, hand hygiene is crucial in preventing the transmission of the infection. Wearing a mask or using an N95 respirator is not necessary for preventing the spread of shigella, as it primarily spreads through the fecal-oral route rather than through respiratory droplets.

3. A school nurse is developing a teaching plan about testicular cancer for a group of clients. Which of the following information should the nurse include in the teaching?

• A. Perform a testicular self-examination weekly.
• B. Do not palpate the epididymis when performing a testicular self-examination.
• C. Expect testicles to be uniform in consistency when performing a testicular self-examination.
• D. Perform a testicular self-examination after a cool shower.

Correct answer: C

Rationale: The correct answer is C because testicles should be uniform in consistency when performing a self-exam, and any lumps or abnormalities should be reported. Choice A is incorrect as testicular self-examinations should be performed monthly, not weekly. Choice B is incorrect because the epididymis should be included in the examination. Choice D is incorrect because a warm shower helps relax the scrotum, making the exam easier to perform.

4. The emergency department has been notified of a potential bioterrorism attack. Which action by the nurse is priority?

• A. Prepare for potential posttraumatic stress related to this bioterrorism attack.
• B. Transport patients quickly and efficiently through the elevators.
• C. Monitor for specific symptoms related to the bioterrorism attack.
• D. Manage all patients using standard precautions.

Correct answer: D

Rationale: During a potential bioterrorism attack, the priority for the nurse is to manage all patients using standard precautions. This approach ensures the safety of both patients and healthcare providers by preventing the spread of potential bioterrorism-related illnesses. Option A is incorrect because managing patient care and safety through standard precautions takes precedence. Option B is incorrect as patient transport should also be done while adhering to infection control measures. Option C is incorrect as monitoring for specific symptoms is important but not the priority when all patients need to be managed with standard precautions.

5. A nurse is preparing to administer medications to a client via a nasogastric (NG) tube. What should the nurse do first?

• A. Crush all medications and administer them all at once.
• B. Flush the NG tube before and after each medication.
• C. Administer only liquid forms of medications.
• D. Skip flushing the tube entirely.

Correct answer: B

Rationale: The correct answer is B: 'Flush the NG tube before and after each medication.' Flushing the NG tube is essential to ensure that the medication passes through smoothly without any obstruction. It helps prevent clogging of the tube and ensures that the full dose of the medication reaches the patient. Options A, C, and D are incorrect because crushing all medications at once, administering only liquid forms of medications, and skipping tube flushing entirely can lead to complications such as tube blockages, incomplete medication administration, and potential harm to the client.

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