Nursing Elites

1. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2-parts: the activity and treatment section and a nursing care plan section. This carries information about basic demographic data, primary medical diagnosis, current orders of the physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in patient care and factors related to daily living activities. This record is used in the charge-of-shift reports or during the bedside rounds or walking rounds. What record is this?

• A. Discharge Summary
• B. Medicine and Treatment Record
• C. Nursing Health History and Assessment Worksheet
• D. Nursing Kardex

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

2. During the acute phase of a burn, the priority nursing intervention in caring for this client is:

• A. Prevention of infection
• B. Pain management
• C. Prevention of bleeding
• D. Fluid resuscitation

Correct answer: D

Rationale: During the acute phase of a burn, fluid resuscitation is the priority nursing intervention. This phase is characterized by fluid loss and the risk of hypovolemic shock. Administering fluids is crucial to maintain perfusion and prevent complications such as organ failure. While prevention of infection, pain management, and prevention of bleeding are important aspects of burn care, fluid resuscitation takes precedence in the acute phase to stabilize the client's condition and prevent further damage.

3. After bronchoscopy, the nurse's priority is to check which of the following before feeding?

• A. Gag reflex
• B. Wearing off of anesthesia
• C. Swallowing reflex
• D. Peristalsis

Correct answer: A

Rationale: After a bronchoscopy procedure, the nurse's priority is to check the patient's gag reflex before allowing them to eat to prevent aspiration. The gag reflex helps protect the airway by triggering a cough or gag response if something touches the back of the throat. This is crucial to ensure that the patient can protect their airway and prevent food or fluids from entering the lungs, especially when the throat may be sensitive or compromised post-bronchoscopy. Checking for the wearing off of anesthesia, swallowing reflex, or peristalsis are important assessments but not the immediate priority before feeding in this context.

4. Which of the following groups of vitamins are fat-soluble?

• A. vitamins B and C
• B. vitamins A and C
• C. vitamins B, E, K, D
• D. vitamins A, E, K, D

Correct answer: D

Rationale: The correct answer is D: vitamins A, E, K, and D. Fat-soluble vitamins are absorbed along with fats in the diet and can be stored in the body's fatty tissue. Vitamins B and C are water-soluble vitamins and are not stored in the body; any excess amounts are usually excreted in the urine. Therefore, choices A, B, and C are incorrect.

5. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer?

• A. Prostaglandins released from the cut fallopian tubes can kill sperm
• B. Sperm cannot enter the uterus because the cervical entrance is blocked
• C. Sperm can no longer reach the ova, because the fallopian tubes are blocked
• D. The ovary no longer releases ova as there is nowhere for them to go

Correct answer: C

Rationale: The correct answer is C: 'Sperm can no longer reach the ova because the fallopian tubes are blocked.' Tubal ligation works by blocking the fallopian tubes, preventing sperm from reaching the egg for fertilization. Choice A is incorrect because prostaglandins are not released from the cut fallopian tubes to kill sperm. Choice B is incorrect as the cervical entrance being blocked does not relate to tubal ligation. Choice D is incorrect because tubal ligation does not affect the release of ova from the ovary.

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