Nursing Elites

1. Which of the following actions can an individual nurse take to exert leadership in supporting the profession of nursing?

• A. Join a local professional organization.
• B. Talk about healthcare issues to everyone who will listen, including legislators.
• C. Register to vote.
• D. Learn about the healthcare system.

Correct answer: B

Rationale: Engaging in conversations about healthcare issues with a wide audience, including legislators, is a powerful way for a nurse to exert leadership and support the nursing profession. This action helps raise awareness, advocate for nursing-related matters, and contribute to positive changes in healthcare policies. Choice A, joining a local professional organization, is beneficial but may not have the same broad impact as engaging in public discourse. Choice C, registering to vote, is important for civic engagement but does not directly relate to exerting leadership in supporting the nursing profession. Choice D, learning about the healthcare system, is valuable for personal development but does not directly address exerting leadership in supporting the nursing profession.

2. Who should document care?

• A. The LPNs should document the care that they provided and the care that was given by unlicensed assistive staff.
• B. The registered nurse must document all of the care that is provided by the nursing assistants because they are accountable for all care.
• C. All staff members should document all of the care that they have provided.
• D. All staff should document all of the care that they have provided but the registered nurse, as the only independent practitioner, signs it.

Correct answer: C

Rationale: All staff members should document the care they provided as part of their accountability and to ensure accurate and comprehensive records. In healthcare settings, it is essential for all staff to document the care they deliver for continuity of care and legal purposes. The registered nurse may sign off on the documentation for oversight purposes, but the responsibility of documenting care extends to all staff involved in patient care. Choices A and B incorrectly limit the responsibility to specific roles, while choice D inaccurately suggests that only the registered nurse signs off on the documentation, overlooking the importance of comprehensive documentation by all staff members involved.

3. A client with a tumor refuses surgery, but the client's partner wants it. Which is the deciding factor in determining if the surgery will be done?

• A. Whether the partner is the client's durable power of attorney for healthcare
• B. Whether the client understands the risk of refusing the procedure
• C. Whether the client's refusal is based on religious belief
• D. Whether the facility's ethical committee reaches a consensus on the case

Correct answer: B

Rationale: The correct answer is B because the client's understanding of the risks involved in refusing the surgery is crucial in determining the course of action. In this scenario, the client's autonomy and decision-making capacity take precedence. Choice A is not directly relevant to the decision-making process regarding surgery. Choice C, religious beliefs, may influence the decision but should not be the determining factor in this case. Choice D involving the facility's ethical committee is not typically involved in individual patient care decisions.

4. A nurse is receiving a verbal prescription from the provider for a client who is experiencing increased pain. The nurse should transcribe which of the following prescriptions in the client's medical record?

• A. Morphine sulfate 10 mg IV q 4 IV prn for pain
• B. MS 10 mg IV every 4 8 prn for pain
• C. MSO4 10 mg IVP q 4 8 prn for pain
• D. Morphine sulfate 10.0 mg every 4 hours IV prn for pain

Correct answer: A

Rationale: The correct transcription is 'Morphine sulfate 10 mg IV q 4 IV prn for pain.' In choice A, 'Morphine sulfate 10 mg IV q 4 IV prn for pain' correctly indicates the medication, route (IV), frequency (every 4 hours), and administration as needed for pain control. Choice B is incorrect as 'MS' is not a standard abbreviation for Morphine Sulfate, and the frequency 'every 4 8' is not a valid time interval. Choice C is incorrect as 'MSO4' is not the standard abbreviation for Morphine Sulfate, and 'IVP' is not the standard route abbreviation for intravenous. Choice D is incorrect as it lacks clarity with '10.0 mg' instead of '10 mg,' and the frequency is given as 'every 4 hours' without specifying the route of administration.

5. Select the stage of viral hepatitis that is accurately paired with its characteristic(s).

• A. The prodromal stage: Jaundice begins
• B. The icteric stage: Flu-like symptoms occur
• C. The pre-icteric stage: Elevated urine bilirubin levels
• D. The post-icteric stage: Jaundice and dark urine occur

Correct answer: D

Rationale: The post-icteric stage of viral hepatitis is accurately described as the stage where jaundice and dark urine occur due to the accumulation of bilirubin. The resolution of jaundice and normalization of urine color are seen in this stage. Choices A, B, and C are incorrect. In the prodromal stage, symptoms like fatigue and malaise appear before jaundice. The icteric stage is characterized by jaundice, not flu-like symptoms. The pre-icteric stage does not typically involve elevated urine bilirubin levels, as this occurs after the icteric stage.

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