Nursing Elites

1. 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.

2. Which of the following most accurately describes a current concern in health care today?

• A. Health care-associated (nosocomial) infections continue to increase, not limited to health-care settings.
• B. Despite preventable deaths increasing from the opioid crisis, life expectancy in the United States has slightly risen over the last 2 years.
• C. Although adverse drug events persist, medication errors have not been completely eliminated through the use of electronic medication administration records.
• D. Gun violence has become a growing public health concern.

Correct answer: D

Rationale: Gun violence has become a growing public health concern due to the increasing rates of injury and death caused by the misuse of firearms. Choice A is incorrect because health care-associated infections are not limited to health-care settings and continue to increase. Choice B is inaccurate as preventable deaths from the opioid crisis have not led to a rise in life expectancy in the United States. Choice C is incorrect as medication errors have not been completely eliminated despite the use of electronic medication administration records.

3. Which statement about glaucoma is true and accurate?

• A. Acute angle-closure glaucoma is an ocular emergency.
• B. Acute angle-closure glaucoma leads to the loss of peripheral vision and tunnel vision.
• C. Primary open-angle glaucoma leads to eye pain, nausea, and vomiting, blurry vision, and halos.
• D. Bubbles are implanted to protect the retina from glaucoma.

Correct answer: A

Rationale: The correct answer is A: 'Acute angle-closure glaucoma is an ocular emergency.' Acute angle-closure glaucoma is indeed considered an ocular emergency that requires immediate attention to prevent vision loss. Choice B is incorrect because acute angle-closure glaucoma commonly presents with symptoms like severe eye pain, headache, blurred vision, and halos around lights. Choice C is incorrect as these symptoms are more indicative of acute angle-closure glaucoma rather than primary open-angle glaucoma. Choice D is incorrect since bubbles are not typically used to protect the retina from glaucoma; treatment usually involves medications, laser therapy, or surgery to manage intraocular pressure.

4. The nurse is planning care for a patient with acute hypernatremia. What should the nurse include in this patient's plan of care? (select one that does not apply)

• A. Reduce IV access
• B. Limit length of visits
• C. Restrict fluids to 1500 mL per day
• D. Conduct frequent neurologic checks

Correct answer: D

Rationale: For a patient with acute hypernatremia, the nurse should include interventions like reducing free water losses, correcting sodium levels slowly, monitoring neurologic status, and ensuring adequate fluid intake. Conducting frequent neurologic checks is essential in assessing the patient's neurological status and detecting any changes promptly. Therefore, this action should not be excluded from the plan of care. Choices A, B, and C are not directly related to managing acute hypernatremia and can be safely excluded from the plan of care. Reducing IV access, limiting length of visits, and restricting fluids to 1500 mL per day are not appropriate actions for managing acute hypernatremia.

5. Which of the following differentiates ulcerative colitis from Crohn's disease?

• A. Crohn's disease primarily affects the left colon and rectum, while ulcerative colitis most often affects the right colon and distal ileum.
• B. Crohn's disease presents with shallow ulcerations, whereas ulcerative colitis presents with a cobblestone appearance of the mucosal lining.
• C. The extent of involvement is noncontiguous and segmented with Crohn's disease, whereas it is contiguous and diffuse with ulcerative colitis.
• D. Crohn's disease has primarily mucosal involvement, whereas it is transmural with ulcerative colitis.

Correct answer: C

Rationale: The correct answer is C. Crohn's disease is characterized by noncontiguous, segmented involvement, meaning it can affect different areas with healthy tissue in between, while ulcerative colitis involves continuous areas of inflammation. Choices A, B, and D are incorrect because Crohn's disease can affect any part of the digestive tract from mouth to anus, can present with shallow ulcerations or deep fissures, and is transmural, meaning it affects the entire thickness of the bowel wall. On the other hand, ulcerative colitis typically affects the colon and rectum, presents with a continuous pattern of inflammation, and primarily involves the mucosal lining of the colon.

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