Nursing Elites

1. When a woman has miscarried in three or more consecutive pregnancies, it is referred to as which type of spontaneous abortion?

• A. Inevitable
• B. Missed
• C. Habitual
• D. Threatened

Correct answer: C

Rationale: The correct answer is C, 'Habitual.' Habitual abortion is defined as three or more consecutive miscarriages, making it the appropriate term for this situation. Choice A, 'Inevitable,' refers to a miscarriage that cannot be prevented. Choice B, 'Missed,' refers to a miscarriage where the fetus has died but has not been expelled. Choice D, 'Threatened,' refers to a situation where there is bleeding in early pregnancy but the cervix remains closed.

2. A nurse is providing an in-service about client rights for a group of nurses. Which of the following statements should the nurse include in the service?

• A. A nurse can disclose information to a family member with the client's permission
• B. A nurse can apply restraints on an as-needed basis
• C. A nurse can administer medications without consent to a client as part of a research study
• D. A nurse is responsible for informing clients about treatment options

Correct answer: A

Rationale: The correct statement to include in the in-service about client rights is that a nurse can disclose information to a family member with the client's permission. This respects the client's autonomy and privacy. Choice B is incorrect because restraints should only be applied based on a specific assessment and order, not on an as-needed basis. Choice C is incorrect as administering medications without consent is a violation of ethical principles and legal standards. Choice D is incorrect because while nurses should educate clients about treatment options, the ultimate decision lies with the client after being informed.

3. A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?

• A. A client who is at 32 weeks of gestation and has premature rupture of membranes
• B. A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor
• C. A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump
• D. A client who has gestational diabetes and is receiving biweekly nonstress tests

Correct answer: C

Rationale: A nurse who floated from a medical-surgical unit would be appropriate to care for a client who is 1 day postoperative following a Cesarean section and has a PCA pump. This client requires monitoring of the postoperative incision site, pain management through the PCA pump, and assessment for any signs of complications related to the surgery. Assigning this client to an RN with experience in postoperative care aligns with providing specialized and appropriate care. Choices A, B, and D involve conditions or procedures specific to obstetrics that would be better managed by a nurse with obstetrical experience, making them incorrect choices for the floated RN.

4. You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?

• A. Obtunded
• B. A persistent vegetative state
• C. Locked-in syndrome
• D. Brain death

Correct answer: B

Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because: A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning. C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking. D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.

5. Which of the following is expected to be most likely true in the near future?

• A. Quality improvement projects will decline due to cost-cutting measures.
• B. Alternative and complementary approaches will gain acceptance in medical practice.
• C. Care will primarily shift away from the hospital setting.
• D. Increased focus on care transitions will involve nursing.

Correct answer: D

Rationale: In the near future, there will be an increased focus on care transitions involving nursing. This means that nurses will play a crucial role in preparing patients for transitions between different care settings, ensuring continuity and quality of care. Choice A is incorrect because quality improvement projects are essential and are not expected to decline. Choice B is incorrect as alternative and complementary approaches are increasingly being integrated into medical practice. Choice C is incorrect as there is a growing trend towards providing care in community settings and homes, moving away from primarily hospital-based care.

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