Nursing Elites

1. The nurse is obtaining a health assessment from the preoperative client scheduled for hip replacement surgery. Which statement by the client would be most important for the nurse to report to the physician?

• A. "I had chickenpox when I was 8 years old."?
• B. "I had rheumatic fever when I was 10 years old."?
• C. "I have a strong family history of gastric cancer."?
• D. "I have pain in my hip with any movement."?

Correct answer: B

Rationale: The most important statement for the nurse to report to the physician is that the client had rheumatic fever when they were 10 years old. This information is crucial as individuals who have had rheumatic fever require pre-medication with antibiotics before any surgical or dental procedure to prevent bacterial endocarditis. Reporting this history ensures the client's safety during the hip replacement surgery. The other options, such as having chickenpox in the past, a family history of gastric cancer, or experiencing hip pain, are important for the client's overall health assessment but do not have the same immediate implications for the upcoming surgery as the history of rheumatic fever.

2. Support systems during the grieving process include all of the following except:

• A. a despondent friend.
• B. a nurse.
• C. a social worker.
• D. a family member.

Correct answer: B

Rationale: During the grieving process, it is essential to have a support system in place. Options B, C, and D - a nurse, a social worker, and a family member, respectively, are individuals who can provide comfort, guidance, and practical assistance to someone who is grieving. However, a despondent friend, as stated in the question, is not an ideal choice for support during this period. A despondent friend is someone who is feeling extremely unhappy and discouraged, and may not have the emotional capacity to provide the needed support to a grieving individual. It is important for someone who is grieving to have support from individuals who can offer understanding, empathy, and strength, which a despondent friend may struggle to provide.

3. Which is an example of a sentinel event?

• A. The terminally ill client is referred to hospice and dies 3 months later.
• B. A client receives an unordered mammogram which reveals a small cyst.
• C. A client with a laceration to the knee requiring 4 sutures falls when getting up unassisted after being instructed to remain in bed.
• D. A client scheduled for knee replacement surgery had an above-the-knee amputation performed.

Correct answer: D

Rationale: Yes! A sentinel event is an unexpected occurrence causing death or serious injury. In this case, a client who was scheduled for knee replacement surgery but had an above-the-knee amputation performed instead represents a sentinel event as it resulted in serious harm that was not intended. The other choices do not meet the criteria for a sentinel event. Choice A describes a natural progression for a terminally ill client, choice B shows an incidental finding from a test, and choice C involves a preventable fall leading to an injury but not a sentinel event.

4. A healthcare professional is reviewing a patient's medical record. The record indicates the patient has limited shoulder flexion on the left. Which plane of movement is limited?

• A. Horizontal
• B. Sagittal
• C. Frontal
• D. Vertical

Correct answer: B

Rationale: The correct answer is 'Sagittal.' The sagittal plane divides the body into left and right halves, and movements in this plane involve flexion and extension. In this case, limited shoulder flexion on the left indicates a restriction in the forward and backward movement of the arm, which occurs in the sagittal plane. Choice A, 'Horizontal,' is incorrect as it refers to movements parallel to the ground. Choice C, 'Frontal,' is incorrect as it involves side-to-side movements. Choice D, 'Vertical,' is incorrect as it typically refers to up and down movements.

5. How can a diet high in fiber content benefit an individual?

• A. aid in rapid weight loss.
• B. reduce diabetic ketoacidosis.
• C. lower cholesterol.
• D. reduce the requirement for folate.

Correct answer: C

Rationale: A diet high in fiber content can help lower cholesterol levels. Fiber-rich foods such as grains, apples, potatoes, and beans are known to aid in reducing cholesterol by binding to cholesterol in the digestive system and preventing its absorption into the bloodstream. Choice A is incorrect as the question does not specify losing weight rapidly but rather focuses on the benefits of a high-fiber diet, which includes aiding in weight management through promoting satiety and regulating digestion. Choice B is incorrect because while fiber helps manage blood sugar levels, it is not directly related to reducing diabetic ketoacidosis, a serious complication of diabetes. Choice D is incorrect as a high-fiber diet does not reduce the need for folate; however, it can aid in the absorption of folate and other essential nutrients.

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