Nursing Elites

1. What is the main purpose of quality improvement in healthcare?

• A. To increase healthcare costs
• B. To improve patient outcomes
• C. To decrease patient satisfaction
• D. To increase hospital stays

Correct answer: B

Rationale: The main purpose of quality improvement in healthcare is to improve patient outcomes by enhancing the quality and safety of healthcare services. Choice A is incorrect because the goal is not to increase healthcare costs but to optimize resources and provide cost-effective care. Choice C is incorrect as the aim is to increase patient satisfaction through better outcomes. Choice D is incorrect as the objective is to reduce hospital stays by improving care efficiency and effectiveness.

2. Select the types of pain that are accurately coupled with an example of it. Select all that are correct.

• A. Radicular pain: Pain shooting down the leg from a herniated disc
• B. Central neuropathic pain: Pain from nerve damage after a stroke
• C. Peripheral neuropathic pain: Pain from diabetic neuropathy in the feet
• D. Chronic pain: Pain lasting for more than 3-6 months

Correct answer: D

Rationale: The correct answer is D because chronic pain is characterized by lasting for a prolonged period, typically more than 3-6 months, and is not necessarily related to acute injuries like a stab wound to the chest. Choices A, B, and C are incorrect because they do not accurately match the type of pain with its corresponding example. Radicular pain is pain that radiates along the nerve path, often from a pinched nerve or herniated disc, not a broken bone. Central neuropathic pain arises from damage to the central nervous system, such as after a stroke, not a leg injury. Peripheral neuropathic pain is caused by damage to the peripheral nerves, such as in diabetic neuropathy, not a fractured leg bone.

3. While administering penicillin intravenously, you notice that the patient becomes hypotensive with a bounding, rapid pulse rate. What is the first action you should take?

• A. Decrease the rate of the intravenous medication flow.
• B. Increase the rate of the intravenous medication flow.
• C. Call the doctor.
• D. Stop the intravenous flow.

Correct answer: D

Rationale: The correct action to take when a patient becomes hypotensive with a bounding, rapid pulse rate after administering penicillin intravenously is to stop the intravenous flow immediately. This can help prevent further complications by discontinuing the administration of the medication that might be causing the adverse effects. Decreasing or increasing the rate of medication flow may not address the underlying issue of the patient's adverse reaction. While it's important to involve the healthcare provider in such situations, the immediate priority is to halt the administration of the medication.

4. Which individual is most at risk for Osgood-Schlatter disease?

• A. An elderly female who is hospitalized with a hip fracture and on bed rest
• B. A middle-aged male patient who has been exposed to asbestos in the shipping industry
• C. An adolescent who is physically active and the captain of their soccer team
• D. An infant of low birth weight and a gestational age of 28 weeks

Correct answer: C

Rationale: Osgood-Schlatter disease is a condition that commonly affects adolescents who are physically active, especially during growth spurts. It is caused by overuse of the knee, leading to inflammation of the patellar ligament at the tibial tuberosity. The repetitive stress on the growth plate during activities like running and jumping can trigger this condition. Therefore, an adolescent who is physically active and the captain of their soccer team is most at risk for Osgood-Schlatter disease. Choices A, B, and D are not at high risk for this condition as it is primarily seen in active adolescents.

5. A nurse in the emergency department is assessing a client who is unconscious following a motor-vehicle crash. The client requires immediate surgery. Which of the following actions should the nurse take?

• A. Transport the client to the operating room without verifying informed consent
• B. Ask the anesthesiologist to sign the consent
• C. Obtain telephone consent from the facility administrator before the surgery
• D. Delay the surgery until the nurse can obtain informed consent

Correct answer: A

Rationale: In emergency situations where a client is unconscious and requires immediate surgery, implied consent applies. Implied consent allows healthcare providers, including nurses, to proceed with necessary treatment or surgery without formally verifying informed consent. Choice A is correct because the priority in this scenario is to ensure the client receives timely medical intervention to address life-threatening conditions. Choices B, C, and D are incorrect because in emergencies, waiting to obtain formal consent can delay critical treatment, risking the client's health and well-being.

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