Nursing Elites

1. The nurse manager has a nurse employee who is suspected of having a problem with chemical dependency. Which intervention would be the best approach by the nurse manager?

• A. Confront the nurse about the suspicions in a private meeting
• B. Schedule a staff conference, without the nurse present
• C. Consult the human resources department about the issue and needed actions
• D. Counsel the employee to resign to avoid investigation

Correct answer: C

Rationale: Consulting with human resources is the best approach in this situation. It ensures that the issue is handled according to the organization's policies and that the nurse receives the appropriate support and intervention needed for chemical dependency. Confronting the nurse directly may lead to defensiveness and hinder a constructive resolution. Scheduling a staff conference without the nurse present can create unnecessary speculation and violate the employee's privacy. Counseling the employee to resign is not appropriate and does not address the underlying problem of chemical dependency.

2. The nurse is planning care for a client with increased intracranial pressure. The best position for this client is

• A. Trendelenburg
• B. Prone
• C. Semi-Fowler's
• D. Side-lying with head flat

Correct answer: C

Rationale: The correct answer is C, Semi-Fowler's. This position helps to reduce intracranial pressure by promoting venous drainage from the head while maintaining adequate oxygenation. Option A, Trendelenburg position, is incorrect as it involves placing the patient with the head lower than the body, which can increase intracranial pressure. Option B, Prone position, is also incorrect as it involves lying on the stomach, which can further elevate intracranial pressure. Option D, Side-lying with head flat, does not provide the same benefits as the Semi-Fowler's position in terms of promoting venous drainage and maintaining oxygenation in a client with increased intracranial pressure.

3. When caring for a child with Reye's Syndrome, which action should the nurse give the highest priority?

• A. Monitor intake and output
• B. Provide good skin care
• C. Assess level of consciousness
• D. Assist with range of motion

Correct answer: C

Rationale: Assessing the level of consciousness is crucial when caring for a child with Reye's Syndrome. Changes in neurological status can indicate deterioration of the condition, necessitating immediate medical attention. Monitoring intake and output is important but not the highest priority compared to assessing the child's level of consciousness. Providing good skin care and assisting with range of motion are also important aspects of care but take a lower priority than assessing the child's neurological status in this critical condition.

4. The RN is planning care at a team meeting for a 2-month-old child in bilateral leg casts for congenital clubfoot. Which of these suggestions by the PN should be considered the priority nursing goal following cast application?

• A. Infant will experience minimal pain
• B. Muscle spasms will be relieved
• C. Mobility will be managed as tolerated
• D. Tissue perfusion will be maintained

Correct answer: D

Rationale: Following cast application for congenital clubfoot in a 2-month-old child, the priority nursing goal should be to maintain tissue perfusion. This is crucial to prevent complications like compartment syndrome and ensure proper healing. While managing pain, relieving muscle spasms, and promoting mobility are important aspects of care, they are secondary to ensuring adequate tissue perfusion in this scenario.

5. A community health nurse is conducting a neighborhood discussion group about disaster planning. What information regarding the transmission of anthrax should the nurse provide to the group?

• A. Infection is acquired when anthrax spores enter a host.
• B. Mature anthrax bacteria live dormant on inanimate objects.
• C. Spores cannot survive for extended periods outside of a living host.
• D. Anthrax is transmitted by respiratory droplets from person to person.

Correct answer: A

Rationale: The correct information that the nurse should provide to the group is that anthrax infection occurs when spores enter a host. Choice B is incorrect because mature anthrax bacteria do not live dormant on inanimate objects. Choice C is incorrect because anthrax spores can survive for extended periods outside of a living host. Choice D is incorrect because anthrax is not transmitted by respiratory droplets from person to person; it is acquired through spores entering a host.

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