Nursing Elites

1. Which of the following syndromes associated with incomplete lesions of the spinal cord results from damage to one-half of the spinal cord?

• A. Brown-Séquard syndrome
• B. posterior cord syndrome
• C. central cord syndrome
• D. cauda equina syndrome

Correct answer: A

Rationale: Brown-Séquard syndrome is indeed associated with incomplete lesions of the spinal cord, and it specifically results from damage to one-half of the spinal cord. This syndrome manifests as ipsilateral motor paralysis, ipsilateral loss of vibration and proprioception, and contralateral loss of pain and temperature sensation. Posterior cord syndrome mainly involves the loss of proprioception and vibratory sense, while sparing motor function and pain sensation. Central cord syndrome typically presents with more weakness in the upper extremities compared to the lower extremities due to central spinal cord damage. Cauda equina syndrome affects the nerve roots at the level of the conus medullaris, leading to symptoms like lower extremity weakness, numbness, and bowel/bladder dysfunction.

2. The nurse notes that a healthcare provider has documented the following prescription in a client's record: Furosemide (Lasix) 40 mg stat once. What action should the nurse take?

• A. Administering the medication
• B. Drawing up the medication in a syringe
• C. Planning to have the nurse on the next shift administer the medication
• D. Contacting the healthcare provider

Correct answer: D

Rationale: The correct action for the nurse to take in this situation is to contact the healthcare provider. The prescription provided lacks crucial information such as the route of administration. Before administering any medication, the nurse must clarify any missing details with the provider, especially for a stat prescription that requires immediate administration. Drawing up or administering the medication without verifying the route of administration is unsafe and can lead to errors. Planning for the next shift nurse to administer the medication is not appropriate in this scenario as the stat order necessitates immediate action. Therefore, the best course of action is to contact the healthcare provider to obtain clarification on the prescription.

3. What is a significant point about Shigella that the nurse should acknowledge upon identifying it in a stool culture?

• A. People who have been in contact with the client need to be tested.
• B. Shigella is an airborne infection.
• C. Shigella is a bacteria sometimes found in stagnant water.
• D. The nurse should wear a one-way breathing apparatus when giving client care.

Correct answer: C

Rationale: Shigella is a bacteria sometimes found in stagnant water. Transmission of Shigella is typically oral-fecal, so good hand washing and the use of gloves are the best means of prevention when caring for a client with Shigella. The bacteria can be found in food and water contaminated by fecal material. Incidences of Shigella are reportable in many states. Choices A, B, and D are incorrect. While it is important for close contacts to be aware and practice good hygiene, testing is not routinely indicated. Shigella is not an airborne infection; it is transmitted through contaminated food or water. A one-way breathing apparatus is not necessary for caring for a patient with Shigella; standard precautions, including handwashing and gloves, are sufficient.

4. A nurse calls a health care provider to question a prescription written for a higher-than-normal dosage of morphine sulfate. The health care provider changes the prescription to a dosage within the normal range, and the nurse documents the new telephone prescription in accordance with the agency's guidelines in the client's record. Which other statement does the nurse document in the nursing notes?

• A. The health care provider made a mistake in the written prescription for morphine sulfate.
• B. An inaccurate dosage of morphine sulfate was prescribed and the health care provider was informed.
• C. The health care provider was contacted to correct a mistake in the dosage of morphine sulfate.
• D. The health care provider was contacted to clarify the prescription for morphine sulfate

Correct answer: D

Rationale: The nurse needs to document a factual, descriptive, and objective statement that does not include words indicating that an individual made a mistake or performed an incorrect action or procedure. If a health care provider's prescription must be questioned, the nurse should record that clarification regarding the prescription was sought. Therefore, the correct statement to document is that the health care provider was contacted to clarify the prescription for morphine sulfate. Choices A, B, and C imply errors or mistakes on the part of the health care provider, which is not the focus of the documentation in this scenario.

5. What is the most effective way to prevent skin breakdown?

• A. assistive devices
• B. repositioning
• C. topical medications
• D. avoiding tape and bandages

Correct answer: V

Rationale: Repositioning is the most effective way to prevent skin breakdown. Repositioning helps relieve pressure on specific areas of the skin, reducing the risk of developing pressure ulcers. While assistive devices (Choice A) may be beneficial in some cases, they are not universally as effective as repositioning. Topical medications (Choice C) are primarily used for treating skin conditions and are not the primary focus for preventing skin breakdown. Avoiding tape and bandages (Choice D) is crucial to prevent skin irritation, but repositioning remains the most effective method to prevent skin breakdown.

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