Nursing Elites

1. Thrombolytic therapy is frequently used in the treatment of suspected stroke. Which of the following is a significant complication associated with thrombolytic therapy?

• A. Air embolism.
• B. Cerebral hemorrhage.
• C. Expansion of the clot.
• D. Resolution of the clot.

Correct answer: B

Rationale: Cerebral hemorrhage is a significant complication associated with thrombolytic therapy in stroke treatment. Thrombolytic therapy aims to dissolve clots, but it increases the risk of bleeding, including cerebral hemorrhage. This risk is especially high when the therapy is administered quickly after a stroke, sometimes before confirming the type of stroke. Air embolism (Choice A) is not a common complication of thrombolytic therapy. Expansion of the clot (Choice C) and resolution of the clot (Choice D) are not expected outcomes of thrombolytic therapy; the therapy is specifically used to dissolve clots, not to expand or resolve them.

2. When a nurse is asked by a physician to speak to a colleague about their unprofessional behavior in front of a client but chooses not to confront the colleague and avoids the physician the next day, what type of conflict resolution is the nurse exhibiting?

• A. Accommodation
• B. Competition
• C. Avoidance
• D. Negotiation

Correct answer: C

Rationale: The nurse is exhibiting the conflict resolution strategy of avoidance. Avoidance involves ignoring the problem in the hope that it will go away on its own. In this scenario, the nurse avoids confronting the colleague and stays away from the physician, which does not address the issue directly. While avoidance may provide time for others to gain insight into the situation, it typically does not lead to a resolution of the underlying problems. Accommodation (A) involves yielding to the wishes of others, competition (B) entails pursuing one's own concerns at the expense of others, and negotiation (D) involves seeking a mutually agreeable solution through communication and compromise, none of which are demonstrated by the nurse in this situation.

3. A new nursing unit is opening in the hospital. In order to meet the staffing needs of the unit, nurses from other areas will be moved and required to work in the new area. When notifying the nurses chosen to staff this area, the nurse manager states, 'You will either move to work on this unit or you will no longer be employed at this hospital.' Which of the following strategies is this nurse manager using?

• A. Manipulation
• B. Facilitation
• C. Co-optation
• D. Coercion

Correct answer: D

Rationale: The nurse manager in this scenario is using a coercion tactic to influence the nurses' job changes. Coercion involves using power to force others to make a choice. In this case, the nurses are left with no option but to either work on the new unit or face termination. Choice A, 'Manipulation,' is incorrect as manipulation involves influencing others through deceit or dishonesty, which is not evident in this situation. Choice B, 'Facilitation,' is incorrect as it refers to the process of making something easier or more convenient, which is not applicable here. Choice C, 'Co-optation,' involves absorbing or integrating individuals into a group, which does not align with the scenario described. Therefore, the most suitable term for the nurse manager's strategy is 'Coercion.'

4. A client in labor has an electronic fetal monitor attached to the abdomen, and the nurse notes that the baby's heart rate slows down during each contraction, returning to normal limits only after the contraction is complete. Which type of fetal heart rate change does this pattern describe?

• A. Variable decelerations
• B. Late decelerations
• C. Early decelerations
• D. Accelerations

Correct answer: B

Rationale: Late decelerations refer to a pattern where the baby's heart rate decreases during contractions and does not return to normal until after the contraction ends. This is considered a non-reassuring sign as it indicates potential fetal distress. Late decelerations are associated with uteroplacental insufficiency, and immediate medical attention is required. Variable decelerations (Choice A) are abrupt, unpredictable decreases in the fetal heart rate, usually associated with cord compression. Early decelerations (Choice C) are usually benign and mirror the contraction pattern. Accelerations (Choice D) are reassuring signs of fetal well-being, characterized by an increase in the fetal heart rate.

5. When a blood pressure cuff is too wide for a client's arm, what type of reading might this blood pressure cuff produce?

• A. A normal reading
• B. An abnormally low reading
• C. An abnormally high reading
• D. A fluctuating reading

Correct answer: B

Rationale: When a blood pressure cuff is too wide for a client's arm, it may produce an abnormally low blood pressure reading. This occurs because the oversized cuff can lead to an underestimation of blood pressure. It is essential to ensure that the cuff fits appropriately to obtain an accurate reading. An abnormally high reading (Choice C) is less likely with an oversized cuff, as it generally leads to lower readings. A normal reading (Choice A) is unlikely due to the inaccuracies caused by the oversized cuff. A fluctuating reading (Choice D) is not a typical result of using a cuff that is too wide; instead, it usually leads to consistently low readings.

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