Nursing Elites

1. The physician's role in case management includes all of the following except:

• A. participating in interdisciplinary planning for clients.
• B. serving as the expert for resource utilization.
• C. consulting with the case management team to facilitate timely orders as needed.
• D. contributing to the documentation of a client's needs for services.

Correct answer: B

Rationale: The correct answer is 'serving as the expert for resource utilization.' While physicians play a crucial role in case management, their primary focus is on medical diagnosis and treatment rather than resource utilization. Choices A, C, and D are all roles that physicians typically fulfill in case management. A physician participating in interdisciplinary planning for clients ensures comprehensive care, consulting with the case management team helps in coordinating timely orders, and contributing to the documentation of a client's needs for services aids in providing appropriate care. Therefore, serving as the expert for resource utilization does not align with the primary responsibilities of a physician in case management.

2. When making an occupied bed, what is important for the nurse to do?

• A. keep the bed in the low position.
• B. use a bath blanket or top sheet for warmth and privacy
• C. constantly keep side rails raised on both sides.
• D. move back and forth from one side to the other when adjusting the linens.

Correct answer: B

Rationale: When making an occupied bed, using a bath blanket or top sheet is important as it keeps the client warm and provides privacy, ensuring their comfort and dignity. Keeping the bed in the low position is crucial for the safety of the client, preventing falls and injuries. Constantly keeping side rails raised on both sides is unnecessary and may restrict the client's movement unnecessarily. Moving back and forth from one side to the other when adjusting the linens is inefficient and disrupts the workflow; it is more effective to work systematically from one side to the other to ensure proper bed-making.

3. Several passengers aboard an airliner suddenly become weak and suffer breathing difficulty. The diagnosis is likely to be

• A. Outbreak of Asian flu.
• B. Chemical exposure.
• C. Bacterial pneumonia.
• D. Allergic reaction.

Correct answer: B

Rationale: In the scenario described, where multiple passengers on an airliner experience sudden weakness and breathing difficulty simultaneously, the most likely cause is chemical exposure. This is because a sudden onset of similar symptoms in a group of individuals suggests a common environmental factor affecting them. Options A, C, and D are less likely as they do not explain a sudden onset of symptoms in multiple individuals simultaneously. Asian flu (Option A) is a viral infection and would not typically result in sudden symptoms in multiple individuals at the same time. Bacterial pneumonia (Option C) is a localized infection and not a probable cause for a sudden onset of symptoms in a group. An allergic reaction (Option D) would usually occur in individuals with specific allergies rather than affecting a group of passengers at the same time.

4. Which of the following syndromes associated with incomplete lesions of the spinal cord results from damage to one-half of the spinal cord?

• A. Brown-S�quard syndrome
• B. posterior cord syndrome
• C. central cord syndrome
• D. cauda equina syndrome

Correct answer: A

Rationale: Brown-S�quard syndrome is indeed associated with incomplete lesions of the spinal cord, and it specifically results from damage to one-half of the spinal cord. This syndrome manifests as ipsilateral motor paralysis, ipsilateral loss of vibration and proprioception, and contralateral loss of pain and temperature sensation. Posterior cord syndrome mainly involves the loss of proprioception and vibratory sense, while sparing motor function and pain sensation. Central cord syndrome typically presents with more weakness in the upper extremities compared to the lower extremities due to central spinal cord damage. Cauda equina syndrome affects the nerve roots at the level of the conus medullaris, leading to symptoms like lower extremity weakness, numbness, and bowel/bladder dysfunction.

5. What is the correct instruction to give a client undergoing mammography?

• A. Do not use underarm deodorant.
• B. Wear comfortable clothing.
• C. Avoid caffeine prior to the procedure.
• D. Bring a list of current medications.

Correct answer: A

Rationale: The correct instruction for a client undergoing mammography is not to use underarm deodorant. Underarm deodorant can cause confusing shadows on the X-ray film, affecting the accuracy of the mammogram. Choices B, C, and D are incorrect. While wearing comfortable clothing is advisable, it is not the primary instruction for mammography. Avoiding caffeine and bringing a list of current medications are not specific instructions related to mammography preparation and are therefore not the correct answers.

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