Nursing Elites

1. You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?

• A. Obtunded
• B. A persistent vegetative state
• C. Locked-in syndrome
• D. Brain death

Correct answer: B

Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because: A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning. C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking. D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.

2. Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?

• A. Leukemia
• B. Histoplasmosis
• C. Pneumocystis jiroveci
• D. Rheumatoid arthritis

Correct answer: D

Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.

3. How do the public view nurses today?

• A. Nurses are assistants to physicians.
• B. Nurses view the person within the family and community.
• C. Nurses are different from other health-care providers.
• D. Nurses are closely involved in shaping the health care of the future.

Correct answer: A

Rationale: The correct answer is A: 'Nurses are assistants to physicians.' The public image of nurses, as portrayed by the media, often positions them as assistants to physicians. This perception stems from historical depictions and the traditional hierarchy within healthcare settings. Choice B is incorrect because it reflects how nurses perceive their patients, not how the public views nurses. Choice C is incorrect as nurses are part of the broader healthcare team but are not seen as fundamentally different from other healthcare providers by the public. Choice D is incorrect as while nurses play a crucial role in shaping healthcare, the public perception often focuses more on their supportive role in the healthcare system.

4. 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.

5. During which stage of anesthesia is a patient most likely to experience involuntary motor activity?

• A. Stage I
• B. Stage II
• C. Stage III
• D. Stage VI

Correct answer: B

Rationale: The correct answer is Stage II. During Stage II of anesthesia, a patient is most likely to experience involuntary motor activity. This stage is known as the excitement stage, where the patient may exhibit purposeful or involuntary movements. Choice A (Stage I) is incorrect because Stage I is the induction phase where the patient is transitioning from consciousness to unconsciousness, and involuntary motor activity is less likely to occur. Choice C (Stage III) is incorrect as it is the stage of surgical anesthesia characterized by muscle relaxation, and involuntary motor activity is less common during this stage. Choice D (Stage VI) is incorrect as there is no Stage VI in the standard stages of anesthesia. Therefore, the most appropriate stage where involuntary motor activity is likely to occur is Stage II.

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