Nursing Elites

1. What is the most important legal responsibility for the healthcare team after a patient's death in a hospital?

• A. Obtaining consent for an autopsy
• B. Notifying the coroner or medical examiner
• C. Labeling the body appropriately
• D. Ensuring the attending physician issues the death certificate

Correct answer: D

Rationale: After a patient's death in a hospital, the most crucial legal responsibility for the healthcare team is ensuring that the attending physician issues the death certificate. The death certificate is a vital legal document that confirms the cause of death and is required for legal and administrative purposes, including the completion of the patient's medical records and facilitating the family's ability to proceed with funeral arrangements and insurance claims. While other actions such as obtaining consent for an autopsy, notifying the coroner or medical examiner, and labeling the body appropriately are important, ensuring the timely and accurate issuance of the death certificate takes precedence in this scenario.

2. A healthcare professional is providing information about tuberculosis to a group of clients at a local community center. Which of the following manifestations should the professional NOT include in the teaching?

• A. Persistent cough
• B. Weight gain
• C. Fatigue
• D. Night sweats

Correct answer: B

Rationale: Weight gain is not a typical manifestation of tuberculosis. The characteristic symptoms of tuberculosis include a persistent cough, fatigue, and night sweats. Weight loss, not weight gain, is a common symptom associated with tuberculosis due to the impact of the infection on the body's metabolism. Therefore, the healthcare professional should exclude weight gain from the teaching on tuberculosis manifestations.

3. When providing discharge teaching for a group of clients, a nurse should recommend a referral to a dietitian for which client?

• A. A client who has a prescription for warfarin and states, 'I will need to limit how much spinach I eat.'
• B. A client who has gout and states, 'I can continue to eat anchovies on my pizza.'
• C. A client who has a prescription for spironolactone and states, 'I will reduce my intake of foods that contain potassium.'
• D. A client who has osteoporosis and states, 'I'll plan to take my calcium carbonate with a full glass of water.'

Correct answer: B

Rationale: The correct answer is the client who has gout and states, 'I can continue to eat anchovies on my pizza.' Gout is a condition that requires dietary modifications to manage symptoms. Anchovies are high in purines, which can exacerbate gout symptoms. Therefore, a referral to a dietitian is essential to provide appropriate dietary guidance for a client with gout. Clients on warfarin may need to monitor their vitamin K intake, particularly from foods like spinach. Clients taking spironolactone should be cautious about potassium-rich foods. Clients with osteoporosis should be educated on the proper administration of calcium supplements but do not necessarily need a dietitian referral for this specific statement.

4. Which of the following signs and symptoms would the nurse expect to find when assessing an Asian patient for postoperative pain following abdominal surgery?

• A. Decreased blood pressure and heart rate and shallow respirations
• B. Quiet crying
• C. Immobility, diaphoresis, and avoidance of deep breathing or coughing
• D. Changing position every 2 hours

Correct answer: C

Rationale: Immobility, diaphoresis, and avoidance of deep breathing or coughing are common signs of pain.

5. Which of the following patients is at greater risk for contracting an infection?

• A. A patient with leukopenia
• B. A patient receiving broad-spectrum antibiotics
• C. A postoperative patient who has undergone orthopedic surgery
• D. A newly diagnosed diabetic patient

Correct answer: A

Rationale: Leukopenia, characterized by low white blood cell count, significantly reduces the body's ability to fight infections. Patients with leukopenia are at a higher risk of contracting infections due to compromised immune defenses.

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