Nursing Elites

1. The nurse is reviewing the hot/cold theory of health and illness. Which statement best describes the basic tenets of this theory?

• A. The causation of illness is based on supernatural forces that influence the humors of the body.
• B. Herbs and medicines are classified based on their physical characteristics of hot and cold and the humors of the body.
• C. The four humors of the body consist of blood, yellow bile, black bile, and phlegm.
• D. The treatment of disease consists of adding or subtracting cold, heat, dryness, or wetness to restore the balance of the humors of the body.

Correct answer: D

Rationale: The hot/cold theory of health and illness is based on the four humors of the body: blood, phlegm, black bile, and yellow bile. These humors regulate the basic bodily functions, described in terms of temperature, dryness, and moisture. The treatment of disease in this theory involves adding or subtracting cold, heat, dryness, or wetness to restore the balance of the humors. Choice A is incorrect as the theory is not based on supernatural forces but on the balance of bodily humors. Choice B is incorrect as herbs and medicines are not classified solely based on their physical characteristics of hot and cold in this theory. Choice C is incorrect as the four humors are blood, phlegm, black bile, and yellow bile, not spiritual connectedness or social aspects. Therefore, the correct choice is D, as it accurately reflects a foundational tenet of the hot/cold theory of health and illness.

2. The instructor is teaching a class on basic assessment skills. Which of the following statements is true regarding the stethoscope and its use?

• A. Slope of the earpieces should point forward toward the examiner's nose.
• B. It blocks out extraneous room noise but does not magnify sound.
• C. The tubing length should be 14 to 18 inches to prevent sound distortion.
• D. Both fit and quality of the stethoscope are important.

Correct answer: B

Rationale: The stethoscope does not magnify sound but effectively blocks out extraneous room noises. The correct orientation of the earpieces is with the slope pointing forward toward the examiner's nose, not posteriorly. The tubing length of a stethoscope should ideally be between 14 to 18 inches (36 to 46 cm) to avoid sound distortion. Using tubing longer than this range can distort sound. Both the fit and quality of the stethoscope are crucial for accurate auscultation and assessment, highlighting their significance in clinical practice. Therefore, the correct answer is that the stethoscope blocks out extraneous room noise but does not magnify sound.

3. Which of the following is an example of physical abuse?

• A. A slap to the person's hand
• B. Threatening the person
• C. Ignoring and isolating a person
• D. Leaving a patient soiled for hours

Correct answer: A

Rationale: The correct answer is 'A slap to the person's hand.' Slapping, hitting, and punching are clear examples of physical abuse. Physical abuse involves actions that can cause physical harm or injury to a person. Choice B, 'Threatening the person,' falls under the category of emotional or psychological abuse, where threats can cause fear and emotional distress but do not involve physical harm. Choice C, 'Ignoring and isolating a person,' is a form of neglect or emotional abuse, not physical abuse. Choice D, 'Leaving a patient soiled for hours,' is an example of neglect or lack of proper care, which is also not classified as physical abuse.

4. During change-of-shift report, the nurse learns about the following four patients. Which patient requires assessment first?

• A. 40-year-old with chronic pancreatitis who has gnawing abdominal pain
• B. 58-year-old who has compensated cirrhosis and is complaining of anorexia
• C. 55-year-old with cirrhosis and ascites who has an oral temperature of 102�F (38.8�C)
• D. 36-year-old recovering from a laparoscopic cholecystectomy who has severe shoulder pain

Correct answer: C

Rationale: When prioritizing patient assessments, the nurse should address the patient with cirrhosis and ascites who has an elevated oral temperature of 102�F (38.8�C) first. This presentation suggests a potential infection, which is critical to address promptly in a patient with liver disease. An infection in a patient with cirrhosis can quickly progress to severe complications. The other options, such as chronic pancreatitis with abdominal pain, compensated cirrhosis with anorexia, and post-laparoscopic cholecystectomy with shoulder pain, do not indicate an immediate life-threatening situation requiring urgent assessment compared to a possible infection in a patient with cirrhosis and ascites.

5. The nurse suspects that a client is withholding health-related information out of fear of discovery and possible legal problems. The nurse formulates nursing diagnoses for the client carefully, being concerned about a diagnostic error resulting from which of the following?

• A. Incomplete data
• B. Generalizing from experience
• C. Identifying with the client
• D. Lack of clinical experience

Correct answer: A

Rationale: In this scenario, the nurse is cautious about potential diagnostic errors due to incomplete data. When a client withholds information, it can lead to incomplete data, which may result in inaccurate nursing diagnoses and care planning. Therefore, the nurse's primary concern is collecting accurate data to make informed clinical decisions. Choices B, C, and D are not relevant to the situation described. Generalizing from experience, identifying with the client, and lack of clinical experience do not directly address the issue of incomplete data impacting the diagnostic process.

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