Nursing Elites

1. Which of the following is a common barrier to effective communication in healthcare?

• A. Active listening
• B. Cultural differences
• C. Clear language
• D. Empathy

Correct answer: B

Rationale: Cultural differences are a common barrier to effective communication in healthcare. When individuals from different cultures interact in healthcare settings, varying communication styles, beliefs, values, and language barriers can hinder effective communication. This can lead to misunderstandings, misinterpretations, and ultimately impact the quality of care provided. Active listening (choice A) is a communication skill that helps improve understanding and can actually enhance communication. Clear language (choice C) is essential for effective communication and can help overcome barriers, rather than being a barrier itself. Empathy (choice D) is important in healthcare to understand patients' emotions and perspectives, but it is not a common barrier to effective communication.

2. A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states she is unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend?

• A. Social worker
• B. Pharmacist
• C. Respiratory therapist
• D. Child protective services

Correct answer: A

Rationale: The correct answer is A: Social worker. A social worker can assist the parent in finding resources to afford the nebulizer. While a pharmacist may provide information about medications and devices, they may not have direct resources to address financial concerns. A respiratory therapist focuses on respiratory care but may not specialize in financial assistance. Referring to child protective services is not appropriate in this scenario as the parent's inability to afford a nebulizer does not indicate neglect or abuse.

3. You have just learned that another nurse was fired for taking photographs of patients without their permission using a cell phone and posting them on Facebook. This nurse was fired because the nurse had:

• A. Violated the law
• B. Acted in a negligent manner
• C. Not completed the proper documentation
• D. Violated an ethical principle

Correct answer: A

Rationale: The correct answer is A: Violated the law. Taking and sharing patient photographs without consent is a violation of patient privacy laws, hence the nurse was fired for breaking the law. Choice B, acting in a negligent manner, is incorrect as the nurse's actions were intentional and not due to negligence. Choice C, not completing proper documentation, is unrelated to the situation described. Choice D, violating an ethical principle, is not specific enough as the primary reason for the nurse's termination was the legal breach regarding patient privacy.

4. A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take?

• A. Proceed with treatment without obtaining written consent
• B. Contact the client's next of kin to obtain consent for treatment
• C. Have the client sign a consent for treatment
• D. Notify risk management before initiating treatment

Correct answer: A

Rationale: In emergency situations where a client is disoriented and has a cardiac arrhythmia, obtaining written consent may not be possible due to the urgency of the situation. The priority is to provide immediate treatment to ensure patient safety. Contacting the next of kin or having the client sign a consent form would cause unnecessary delays in providing critical care. Notifying risk management before initiating treatment is not the most appropriate action when dealing with a time-sensitive situation like a cardiac arrhythmia.

5. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should:

• A. Call the physician
• B. Encourage the intake of fluids
• C. Administer the insulin as ordered
• D. Give the client ½ cup of orange juice

Correct answer: C

Rationale: In this scenario, the client with type 1 DM has a high glucose level at bedtime. The appropriate action for the nurse is to administer the sliding scale insulin as ordered. This insulin regimen is specifically designed to manage high blood glucose levels. Calling the physician is not necessary as the protocol for sliding scale insulin is already in place. Encouraging fluid intake or providing orange juice is not the correct intervention for addressing high blood glucose levels in this case.

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