Nursing Elites

1. If the client is receiving peritoneal dialysis and the dialysate returns cloudy, what should the nurse do?

• A. Document the finding
• B. Send a specimen to the lab
• C. Strain the dialysate
• D. Obtain a complete blood count

Correct answer: B

Rationale: When the dialysate returns cloudy, it could indicate the presence of infection, and sending a specimen to the lab for evaluation is crucial to determine the cause. Documenting the finding alone, as in choice A, may not provide enough information for proper intervention. Straining the dialysate, as in choice C, is not a standard practice and may not help identify the underlying issue. Obtaining a complete blood count, as in choice D, is not directly related to addressing cloudiness in the dialysate. However, the healthcare provider might order a white blood cell count to assess for infection.

2. The nurse notes the patient care assistant looking through the personal items of the client with cancer. Which action should be taken by the registered nurse?

• A. Notify the police department for investigation
• B. Report this behavior to the charge nurse
• C. Monitor the situation and document any suspicious activities
• D. Confront the patient care assistant immediately

Correct answer: B

Rationale: The appropriate action for the registered nurse in this scenario is to report the behavior to the charge nurse. This allows for proper investigation and intervention. Inappropriate actions include notifying the police directly without following the chain of command (Choice A), monitoring without immediate action (Choice C), and confronting the assistant without involving a superior (Choice D). By reporting to the charge nurse, the situation is escalated appropriately within the healthcare setting, ensuring the well-being and safety of the client.

3. Which statement reflects a primary belief of psychiatric mental health nursing?

• A. Most people have the potential to change and grow.
• B. Every person is worthy of dignity and respect.
• C. Human needs are individual to each person.
• D. Some behaviors have no meaning and cannot be understood.

Correct answer: B

Rationale: The correct answer reflects a primary belief of psychiatric mental health nursing, which is that every person is worthy of dignity and respect. This belief forms the foundation of providing holistic and compassionate care in mental health nursing. While it is true that most people have the potential to change and grow, this choice does not directly address a core belief of mental health nursing. Human needs being individual to each person is a general principle of nursing care but does not specifically capture a primary belief in psychiatric mental health nursing. The statement that some behaviors have no meaning and cannot be understood contradicts the fundamental principle that all behavior has meaning and can be understood from the client's perspective in psychiatric mental health nursing.

4. A contraindication for topical corticosteroid use in a client with atopic dermatitis (eczema) is:

• A. parasitic infection
• B. fungal infection
• C. spirochetal infection
• D. viral infection

Correct answer: D

Rationale: Topical corticosteroids are mainly used for their localized effects. When treating atopic dermatitis with a steroidal preparation, there is a risk of the site being vulnerable to invasion by organisms. Viruses like herpes simplex or varicella zoster pose a threat of disseminated infection. Therefore, viral infection is a contraindication for topical corticosteroid use in clients with atopic dermatitis. It is crucial to educate clients using topical corticosteroids to avoid crowds or people with infections and to promptly report any signs of infection. Choices A, B, and C (parasitic, fungal, and spirochetal infections) are not typically contraindications for topical corticosteroid use in the context of atopic dermatitis, as these agents do not pose the same risk of disseminated infection or systemic effects as viral infections.

5. The client returns to the unit from surgery with a blood pressure of 90/50, pulse 132, respirations 30. Which action by the nurse should receive priority?

• A. Continue monitoring the vital signs
• B. Contact the physician
• C. Ask the client how they feel
• D. Ask the LPN to continue post-op care

Correct answer: B

Rationale: The priority action for the nurse is to contact the physician immediately due to the client's abnormal vital signs. A blood pressure of 90/50, pulse of 132, and respirations of 30 indicate instability and require prompt medical attention. Continuing to monitor vital signs, as in choice A, may lead to a delay in necessary interventions. Asking the client how they feel, as in choice C, provides subjective data and does not address the urgent need for medical intervention. Involving the LPN, as in choice D, is not appropriate in this critical situation where the client's condition is unstable and requires immediate physician assessment and intervention.

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