Nursing Elites

1. What are the signs of infection that should be monitored in a postoperative patient?

• A. Fever and chills
• B. All of the above
• C. Increased pain or tenderness
• D. Redness, swelling, and warmth at the surgical site

Correct answer: D

Rationale: The correct answer is D: 'Redness, swelling, and warmth at the surgical site.' These are specific signs of infection at the surgical site that a nurse should monitor for in a postoperative patient. While fever, chills, and increased pain can also indicate infection, the most direct signs are redness, swelling, and warmth at the surgical site. Therefore, 'D' is the best choice as it directly relates to the site of the surgery and is crucial to monitor for potential postoperative infections.

2. After a case manager completes a history and physical assessment for a client with COPD, which of the following actions should the case manager take next?

• A. Call the provider with a list of client concerns.
• B. Identify the client's current health needs.
• C. Compile a list of community resources for the client.
• D. Refer the client to a COPD support group.

Correct answer: A

Rationale: After completing a history and physical assessment for a client with COPD, the next step for the case manager should be to call the provider with a list of client concerns. This is crucial as the provider needs to be informed about any issues or changes in the client's health status to ensure appropriate management. Identifying the client's current health needs, as mentioned in option B, is important but would typically follow after communicating the client's concerns to the provider. Compiling a list of community resources (option C) and referring the client to a COPD support group (option D) are also valuable actions but are not the immediate next steps after completing the assessment.

3. A nurse notices another nurse skipping hand hygiene. What is the appropriate course of action?

• A. Ignore the situation to maintain team harmony.
• B. Report the behavior to the supervisor.
• C. Discuss the issue with the nurse directly.
• D. Do nothing and continue with patient care.

Correct answer: B

Rationale: Correct hand hygiene is crucial for preventing the spread of infections and ensuring patient safety. When a nurse observes another healthcare worker skipping hand hygiene practices, it is essential to report this behavior to the supervisor. Reporting ensures that appropriate action is taken to address the issue and maintain a safe environment for patients. Ignoring the situation (Choice A) may compromise patient safety. Discussing the issue directly with the nurse (Choice C) may not always be effective in ensuring compliance. Doing nothing and continuing with patient care (Choice D) disregards the importance of infection control protocols.

4. A nurse is caring for a patient with an infection. Which laboratory result is most important to monitor?

• A. White blood cell count (WBC)
• B. C-reactive protein (CRP)
• C. Erythrocyte sedimentation rate (ESR)
• D. Hemoglobin and hematocrit levels

Correct answer: A

Rationale: The correct answer is A: White blood cell count (WBC). Monitoring the white blood cell count is crucial when caring for a patient with an infection as it helps assess the body's response to the infection. An elevated white blood cell count often indicates an active infection or inflammation, while a decreasing count may signal improvement or potential complications. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are nonspecific markers of inflammation and not as specific to monitoring infection progression as the white blood cell count. Hemoglobin and hematocrit levels are important for assessing oxygen-carrying capacity and blood volume, but they are not the primary indicators for monitoring infection.

5. A family was referred to crisis intervention services after a natural disaster. One family member refuses to attend, stating, 'No way, I'm not crazy.' What is the nurse's best response?

• A. Don't worry now. The psychiatrists are well trained to help.
• B. Many times, disasters can create mental health problems, so you really should participate with your family.
• C. This will help your family communicate better.
• D. Seeking this kind of help does not mean that you have a mental illness; it is a short-term problem-solving technique.

Correct answer: D

Rationale: The nurse should reassure the family member that seeking help does not imply mental illness, but is part of coping with the disaster.

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