Nursing Elites

1. While a team effort is necessary in the operating room (OR) for efficient and quality patient care delivery, the number of people in the room should be limited for infection control purposes. Which roles comprise this team?

• A. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly
• B. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
• C. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
• D. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

Correct answer: B

Rationale: The roles typically present in an operating room team include the surgeon, assistants (which may include an assistant surgeon), scrub nurse, circulating nurse, and anesthesiologist. These roles are directly involved in the operation and patient care. Choice B is correct. Choice A includes a radiologist and an orderly, who are not typically part of the immediate surgical team in the OR. Choice C includes a pathologist, who usually works in a laboratory outside of the OR. Choice D includes an intern, who may or may not be part of the team, depending on the specific circumstances and hospital policy. These explanations make choices A, C, and D incorrect.

2. A client who was normal weight before pregnancy asks about the recommended weight gain during pregnancy. What should the nurse advise?

• A. 18-40 pounds
• B. 25-35 pounds
• C. 11-20 pounds
• D. 15-25 pounds

Correct answer: B

Rationale: The correct answer is B: 25-35 pounds. According to standard prenatal guidelines, a client with a normal pre-pregnancy weight is recommended to gain between 25-35 pounds during pregnancy. This weight gain is important for the overall health of the mother and the developing baby. Choices A, C, and D are incorrect because they do not fall within the recommended weight gain range for a client with a normal pre-pregnancy weight.

3. When should a newborn transition to whole milk according to dietary teaching for breastfeeding parents?

• A. 6 months
• B. 8 months
• C. 10 months
• D. 12 months

Correct answer: D

Rationale: Breast milk or formula should be the primary source of nutrition for infants up to around 1 year of age. The transition to whole cow's milk is recommended at 12 months of age, not earlier. Introducing whole milk before 12 months can lead to digestive issues and nutrient deficiencies. Therefore, choices A, B, and C are incorrect as they suggest transitioning to whole milk before the recommended age of 12 months.

4. Nurse Edna thinks that the patient is somewhat like his father. She then identifies positive feeling for the patient that affects the objectivity of her nursing care. This emotional reaction is called:

• A. Transference
• B. Counter Transference
• C. Reaction formation
• D. Sympathy

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

5. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

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