Nursing Elites

1. When a physician removes a chest tube, which type of dressing is recommended to be placed over the site?

• A. transparent dressing
• B. colloidal dressing
• C. petrolatum gauze
• D. nonadherent dressing

Correct answer: C

Rationale: Petrolatum gauze is recommended to be placed over the site when a physician removes a chest tube because it forms an airtight seal, helping prevent air from entering the pleural space. This airtight seal is crucial to avoid complications such as a pneumothorax. Transparent dressing is not ideal for this purpose as it may not provide a sufficient seal due to its design. Colloidal dressing and nonadherent dressing are also not suitable for chest tube removal sites as they do not offer the same level of protection against air leakage and may not provide the necessary sealing properties.

2. A risk management program within a hospital is responsible for all of the following except:

• A. identifying risks.
• B. controlling financial loss due to malpractice claims.
• C. ensuring that staff follow their job descriptions.
• D. analyzing risks and trends to guide further interventions or programs.

Correct answer: C

Rationale: A risk management program within a hospital is responsible for identifying risks, controlling financial loss due to malpractice claims, and analyzing risks and trends to guide further interventions or programs. It is not responsible for ensuring that staff follow their job descriptions. Monitoring staff adherence to their job descriptions falls under the purview of departmental managers or supervisors. The primary focus of a risk management program is to assess, mitigate, and manage risks related to patient safety, quality of care, and financial implications, rather than overseeing staff job descriptions.

3. While on the wound care team, the nurse notices that a fellow nurse opens extra colloid dressings that are often thrown away when they are not needed. What should the nurse do?

• A. Do nothing, as it is not impacting client care.
• B. Discuss with the colleague the concern about wasting supplies.
• C. Tell the charge nurse to stop ordering these dressings.
• D. Remove the colloid dressings from the shelf so that the nurse will find other supplies to use.

Correct answer: B

Rationale: The correct answer is to discuss with the colleague the concern about wasting supplies. By addressing this issue, the nurse can promote cost-effective care within the unit. While it may not directly impact client care, the wastage of supplies affects the unit's supply cost, making choice A incorrect. Choice C is incorrect as it assumes the charge nurse is solely responsible for the ordering process and overlooks the opportunity for direct communication between colleagues. Choice D is incorrect as it involves taking matters into one's own hands rather than addressing the issue through communication and collaboration.

4. A client with cirrhosis of the liver presents with ascites. The physician is to perform a paracentesis. For safety, the nurse should ask the client to:

• A. drink 1000 cc of fluid prior to the procedure to aid in fluid loss.
• B. eat foods low in fat.
• C. empty his bladder prior to the procedure.
• D. assume the prone position.

Correct answer: C

Rationale: When performing a paracentesis, the client must be sitting up to allow the fluid to settle in the lower abdomen. To prevent trauma to the bladder while inserting a needle to aspirate the fluid, the bladder must be empty. Choice A is incorrect as excessive fluid intake can make the procedure more difficult due to increased abdominal distension. Choice B is unrelated to the procedure of paracentesis. Choice D is incorrect as the client should be sitting up, not in the prone position, during the procedure.

5. The client asks the nurse not to tell anyone outside of the care team about his positive HIV diagnosis. What response is most appropriate?

• A. "I have to inform all clients on the unit of your diagnosis as it is transmissible."?
• B. "I will not communicate your diagnosis to anyone without your permission."?
• C. "Because this is a communicable disease, it may need to be reported to the CDC."?
• D. "You should not be concerned with who I share your diagnosis with."?

Correct answer: C

Rationale: The most appropriate response is C: "Because this is a communicable disease, it may need to be reported to the CDC."? It is important to uphold patient confidentiality, but in the case of certain communicable diseases like HIV, there are legal requirements for mandatory reporting to public health authorities such as the CDC. Option A is incorrect because it violates patient confidentiality and does not consider legal obligations. Option B, while respecting the client's wishes, may not align with the legal requirement for reporting certain communicable diseases. Option D is inappropriate as it dismisses the client's concerns and rights regarding their health information.

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