Nursing Elites

1. Which of the following is considered an internal disaster?

• A. A patient fall
• B. The massive spread of pneumonia
• C. A computer hacking episode
• D. Unexpected staff absences due to illness

Correct answer: C

Rationale: A computer hacking episode is considered an internal disaster as it disrupts the internal operations of the healthcare facility, compromising data security and potentially impacting patient care. Choices A, B, and D do not directly relate to internal disasters in a healthcare setting. A patient fall is a patient safety issue, the massive spread of pneumonia is a public health concern, and unexpected staff absences due to illness may affect staffing levels but are not typically classified as internal disasters.

2. Which type of practice is most similar to research-based practice?

• A. Best practices
• B. Evidence-based practice
• C. Benchmark practices
• D. Standard-based practice

Correct answer: B

Rationale: The correct answer is B: Evidence-based practice. Evidence-based practice relies on research to guide clinical decisions, mirroring the approach of research-based practice. Choice A, Best practices, refers to established methods or techniques that are widely accepted as superior. Choice C, Benchmark practices, typically involves setting standards or goals for performance comparison. Choice D, Standard-based practice, usually pertains to adhering to established norms or guidelines.

3. A nurse is caring for a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue the client's feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make?

• A. You should contact the provider about your wishes for your family member.
• B. We'll need to have the nursing supervisor review the client's advance directives.
• C. You should speak with the facility's ethics committee about your concerns.
• D. As the health care surrogate, the client's partner can make this decision.

Correct answer: D

Rationale: The correct response is D because the health care surrogate, as designated by the client, has the legal authority to make healthcare decisions on behalf of the client when they are unable to do so. This authority includes decisions about treatment continuation or withdrawal. Option A is incorrect as the family member's wishes do not override the legal authority of the health care surrogate. Option B is not the most appropriate action in this situation as the advance directives are already clear by the designation of a health care surrogate. Option C is not necessary at this stage since the health care surrogate can make the decision without involving the ethics committee.

4. A patient is admitted to the emergency department with hypovolemia. Which IV solution should the nurse anticipate administering?

• A. 3% sodium chloride
• B. 10% dextrose in water
• C. 0.45% sodium chloride
• D. Lactated Ringer's solution

Correct answer: D

Rationale: Lactated Ringer's solution is the most suitable IV solution for a patient with hypovolemia. It is a balanced crystalloid solution containing electrolytes such as sodium, chloride, potassium, calcium, and lactate, which closely resemble the body's natural fluids. This solution helps to restore intravascular volume and electrolyte balance in hypovolemic patients. Choice A, 3% sodium chloride, is a hypertonic solution used for specific situations like severe hyponatremia or cerebral edema, not typically for hypovolemia. Choice B, 10% dextrose in water, is a hypertonic solution primarily used for providing calories and free water, not for volume expansion. Choice C, 0.45% sodium chloride, is a hypotonic solution used for conditions like hypernatremia or as maintenance fluid, not for hypovolemia.

5. Which of the following is the best way to improve nursing's image?

• A. Uniforms should reflect your professionalism.
• B. Introduce yourself with your full name.
• C. Understand the essence of professional behavior in your practice.
• D. Take every opportunity to speak to the public about nursing.

Correct answer: D

Rationale: The correct answer is D because taking every chance to engage with the public about nursing allows for the improvement of nursing's image and the promotion of the profession. Choice A is incorrect as uniforms should reflect professionalism rather than personality. Choice B is not directly related to improving nursing's image. Choice C, while important, does not directly address improving the image of nursing through public engagement.

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