Nursing Elites

1. What is the purpose of performing quality control?

• A. Create a paper trail to show that the laboratory is compliant with OSHA standards for quality control.
• B. Improve the odds that the results reported for any given test are as accurate and reliable as possible.
• C. Be required by law to be part of a quality assurance program.
• D. All of the above

Correct answer: B

Rationale: The primary purpose of performing quality control is to enhance the accuracy and reliability of test results. Quality controls are crucial for ensuring the reliability of each analyte tested. While quality control is not mandated by specific laws, accrediting bodies often require it to maintain accreditation. Creating a paper trail and legal requirements are not the primary objectives of quality control, making choices A and C incorrect. Therefore, the correct answer is to improve the accuracy and reliability of reported test results.

2. A nurse is assessing a client's pulse oximetry on the surgical unit. As part of routine interventions, the nurse turns off the exam light over the client's bed. Which of the following best describes the rationale for this intervention?

• A. External light sources may cause falsely high oximetry values
• B. A bright light in the client's face may cause a low pulse oximetry
• C. External light sources may cause falsely low oximetry values
• D. The client needs a dark and quiet room to recover and maintain proper oxygenation

Correct answer: A

Rationale: When assessing a client's pulse oximetry values, the nurse should turn off any extra environmental lights that are unnecessary, including exam lights or over-bed lights. External light sources may cause falsely high oximetry values when the extra light interferes with the sensor of the oximeter, leading to inaccurate readings. Choice B is incorrect because a bright light in the client's face would not directly affect the pulse oximetry values. Choice C is incorrect as external light sources typically cause falsely high, not low, oximetry values. Choice D is incorrect as the primary reason for turning off the light is to prevent falsely high readings, not solely for the client's comfort.

3. All hospitals and nursing homes are mandated to have the goal of a restraint-free environment. The best way to achieve this goal is to ________________.

• A. ban the use of all restraints under all circumstances
• B. limit restraints to only those situations when falls cannot be prevented
• C. keep all bedside rails up for all patients during nighttime hours
• D. use non-skid socks and sheets to prevent falls from chairs

Correct answer: B

Rationale: All hospitals and nursing homes are mandated by JCAHO and state departments of health to have the goal of a restraint-free environment. This does not mean that no restraints can ever be used under any circumstances. The goal is to minimize the use of restraints and prioritize other preventive measures. Restraining a patient should only be considered when all other preventive strategies have failed, and the patient is at risk of harm. Therefore, the best approach is to limit the use of restraints to situations where falls cannot be prevented, ensuring that restraints are used as a last resort to maintain patient safety. Choices C and D are not ideal solutions as they do not address the appropriate use of restraints in a restraint-free environment.

4. A client is admitted to a nursing unit with a remittent fever. Which statement best describes this pattern of fever?

• A. A fever that spikes and then lowers without returning to normal
• B. A fever that lasts 2 days followed by normal temperature for 2 days, followed by fever again
• C. A fever that lasts 2 days followed by normal temperature for 12 hours, followed by fever again
• D. A persistent fever that has lasted over 24 hours

Correct answer: A

Rationale: A remittent fever is characterized by temperature fluctuations where the fever spikes and then lowers but does not return to normal temperature. Option A best describes this pattern of fever. Option B describes a pattern of fever known as a biphasic fever, where the fever alternates between days of fever and normal temperature. Option C describes a pattern of fever that is more indicative of an intermittent fever, where the fever lasts for a specific duration followed by an interval of normal temperature. Option D does not accurately describe a remittent fever, as it suggests a persistent fever that has lasted over 24 hours, which is not specific to the remittent pattern.

5. A patient in the cardiac unit is concerned about the risk factors associated with atherosclerosis. Which of the following are hereditary risk factors for developing atherosclerosis?

• A. Family history of heart disease
• B. Overweight
• C. Smoking
• D. Age

Correct answer: A

Rationale: A family history of heart disease is an inherited risk factor for developing atherosclerosis. This factor is not modifiable through lifestyle changes. Studies have shown that having a first-degree relative with heart disease significantly increases the individual's risk of developing atherosclerosis. Overweight, smoking, and age are not hereditary risk factors for atherosclerosis. Overweight and smoking are lifestyle-related risk factors, while age is a non-modifiable risk factor that increases with time but is not directly inherited.

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