Nursing Elites

1. You have just learned that another nurse was fired for taking photographs of patients without their permission using a cell phone and posting them on Facebook. This nurse was fired because the nurse had:

• A. Violated the law
• B. Acted in a negligent manner
• C. Not completed the proper documentation
• D. Violated an ethical principle

Correct answer: A

Rationale: The correct answer is A: Violated the law. Taking and sharing patient photographs without consent is a violation of patient privacy laws, hence the nurse was fired for breaking the law. Choice B, acting in a negligent manner, is incorrect as the nurse's actions were intentional and not due to negligence. Choice C, not completing proper documentation, is unrelated to the situation described. Choice D, violating an ethical principle, is not specific enough as the primary reason for the nurse's termination was the legal breach regarding patient privacy.

2. 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.

3. A client with a tumor refuses surgery, but the client's partner wants it. Which is the deciding factor in determining if the surgery will be done?

• A. Whether the partner is the client's durable power of attorney for healthcare
• B. Whether the client understands the risk of refusing the procedure
• C. Whether the client's refusal is based on religious belief
• D. Whether the facility's ethical committee reaches a consensus on the case

Correct answer: B

Rationale: The correct answer is B because the client's understanding of the risks involved in refusing the surgery is crucial in determining the course of action. In this scenario, the client's autonomy and decision-making capacity take precedence. Choice A is not directly relevant to the decision-making process regarding surgery. Choice C, religious beliefs, may influence the decision but should not be the determining factor in this case. Choice D involving the facility's ethical committee is not typically involved in individual patient care decisions.

4. 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.

5. The doctor has ordered 1,000 cc of intravenous fluid every 8 hours. You will be using intravenous tubing that delivers 20 cc/drop. At what rate will you adjust the intravenous fluid flow? _____ gtts per minute.

• A. 38 gtts/min
• B. 42 gtts/min
• C. 50 gtts/min
• D. 40 gtts/min

Correct answer: D

Rationale: To calculate the rate: 1000 cc/8 hours = 125 cc/hour. 125 cc/hour * 1 drop/20 cc * 1 hour/60 minutes = 40 gtts/min. Therefore, the correct answer is 40 gtts/min. Choice A (38 gtts/min) is incorrect as it doesn't match the calculation result. Choice B (42 gtts/min) is incorrect as it is not the calculated rate. Choice C (50 gtts/min) is incorrect as it is not the calculated rate either.

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