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 patient with an infection. Which laboratory result is most important to monitor?

• A. White blood cell count (WBC)
• B. C-reactive protein (CRP)
• C. Erythrocyte sedimentation rate (ESR)
• D. Hemoglobin and hematocrit levels

Correct answer: A

Rationale: The correct answer is A: White blood cell count (WBC). Monitoring the white blood cell count is crucial when caring for a patient with an infection as it helps assess the body's response to the infection. An elevated white blood cell count often indicates an active infection or inflammation, while a decreasing count may signal improvement or potential complications. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are nonspecific markers of inflammation and not as specific to monitoring infection progression as the white blood cell count. Hemoglobin and hematocrit levels are important for assessing oxygen-carrying capacity and blood volume, but they are not the primary indicators for monitoring infection.

3. A nurse is preparing to administer a high dose of morphine to a patient with terminal cancer. What is the nurse's primary consideration before administration?

• A. Ensure the family is aware of the dosage to be administered.
• B. Monitor the patient for respiratory depression.
• C. Administer the morphine in divided doses.
• D. Delay administration until the next assessment.

Correct answer: B

Rationale: The correct answer is B: Monitor the patient for respiratory depression. When administering a high dose of morphine, the nurse's primary consideration should be to monitor the patient for respiratory depression, as morphine can slow down breathing, especially in higher doses. Option A is incorrect because the primary focus should be on the patient's well-being and safety rather than family awareness at this point. Option C is not the best approach as the immediate concern is monitoring the patient closely for any adverse effects. Option D is not advisable as delaying administration without a valid reason can compromise pain management in a terminal cancer patient.

4. What is the definition of malpractice in the context of professional negligence?

• A. Failure to follow personal standards of care
• B. Failure to act in a reasonable and prudent manner by a professional
• C. Harm caused by a healthcare team due to miscommunication
• D. Failure to document patient care properly

Correct answer: B

Rationale: The correct definition of malpractice in the context of professional negligence is the failure to act in a reasonable and prudent manner by a professional. This choice is correct because malpractice occurs when a professional does not meet the standard of care expected in their field, leading to harm or injury to the client. Choices A, C, and D are incorrect because malpractice is specifically about the failure to meet professional standards of care, rather than personal standards, miscommunication within a healthcare team, or inadequate documentation of patient care.

5. When teaching a patient with a new prescription for brimonidine to treat open-angle glaucoma, what indicates an understanding of the instructions?

• A. I can expect my vision to improve quickly
• B. I should use it only when my eyes are irritated
• C. I can expect to feel some irritation when I put these drops in my eyes
• D. I will need regular eye exams

Correct answer: C

Rationale: The correct answer is C. When using brimonidine to treat open-angle glaucoma, patients may experience temporary irritation in the eyes. Choice A is incorrect because vision improvement from brimonidine is not immediate. Choice B is incorrect as brimonidine should be used as prescribed, not just when eyes are irritated. Choice D is important but does not directly indicate an understanding of the medication's use.

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