Nursing Elites

1. You have noticed that the last several patients you have cared for have had questionable blood pressure readings from their arterial lines. When checked against cuff pressures, a discrepancy has been noted, and further investigation has revealed faulty transducers. This is not the first product issue with this company. What positive step could you take to help resolve this situation?

• A. Use the old stock from a previous company
• B. Verify the cuff pressures every hour to ensure accuracy
• C. Notify the risk manager
• D. Form a peer workgroup to evaluate new products

Correct answer: D

Rationale: Forming a peer workgroup to evaluate new products would be an excellent opportunity for collaboration among peers, management, and the purchasing department. When clinicians are engaged to work toward solutions that address patient care issues, they experience more empowerment and control over their work environments. Choice A is incorrect because using old stock from a previous company does not address the root cause of the faulty transducers from the current company. Choice B is incorrect as verifying cuff pressures every hour does not directly address the issue of faulty transducers. Choice C is less effective than forming a peer workgroup as it involves only notifying the risk manager without involving a collaborative effort to resolve the product issue.

2. Your patient has been diagnosed with a left ankle sprain. On the discharge instructions, the physician has prescribed the RICE protocol. This acronym stands for:

• A. Rest, Ice, Compression, Elevation
• B. Radiology, Ice, Compression, Elevation
• C. Rest, Ice, Cast, Elevation
• D. Radiology, Ice, Cast, Elevation

Correct answer: A

Rationale: The correct answer is Rest, Ice, Compression, Elevation. This acronym, RICE, is commonly used for the treatment of injuries like an ankle sprain. Rest allows the injured area to heal, Ice helps reduce swelling and pain (20 minutes on each hour while awake), Compression is usually achieved with an elastic bandage to minimize swelling, and Elevation of the foot above the level of the heart assists in reducing swelling and promoting healing. Choices B, C, and D are incorrect because they include irrelevant terms like Radiology and Cast, which are not part of the standard treatment protocol for an ankle sprain.

3. A client diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication should a nurse expect a physician to order to address this type of symptom?

• A. Haloperidol (Haldol) to address the negative symptom
• B. Clonazepam (Klonopin) to address the positive symptom
• C. Risperidone (Risperdal) to address the positive symptom
• D. Clozapine (Clozaril) to address the negative symptom

Correct answer: C

Rationale: The correct medication to address the symptom described, where the client is slow to respond and appears to be listening to unseen others, is Risperidone (Risperdal). Risperidone is an atypical antipsychotic that is commonly used to manage positive symptoms of schizophrenia. Positive symptoms can include hallucinations, delusions, and disorganized thinking. Haloperidol (Haldol) and Clozapine (Clozaril) are typically used for addressing negative symptoms, such as lack of motivation or social withdrawal. Clonazepam (Klonopin) is a benzodiazepine primarily used for anxiety disorders and seizures, not for addressing symptoms of schizophrenia.

4. A 32-year-old pregnant woman comes to the clinic for her prenatal visit. The nurse gathers data about her obstetric history, which includes 3-year-old twins at home and a miscarriage 10 years ago at 12 weeks gestation. How would the nurse accurately document this information?

• A. G4 T1 P0 A1 L2
• B. G3 T1 P0 A1 L2
• C. G3 T0 P1 A1 L2
• D. G4 T0 P1 A1 L2

Correct answer: D

Rationale: The correct answer is G4 T1 P0 A1 L2. This documentation accurately represents the woman's obstetric history. G4: She is currently pregnant (1), has twins (1), and had a miscarriage (1), totaling four pregnancies. T1: She has had one pregnancy that resulted in the birth of her twins at term. P0: She has not had any preterm births. A1: She had one miscarriage at 12 weeks gestation. L2: She has two living children (the twins). Therefore, the correct documentation reflects all aspects of her obstetric history as provided.

5. A physician is explaining a procedure to a patient that may cure her recurring Staph infection. The doctor explains how the procedure is done, what to expect, the odds of the procedure curing the infection, and possible side effects and risks. The physician is:

• A. Preparing the patient to give informed consent.
• B. Protecting HIPAA by listing all the steps of the procedure with the risks involved.
• C. Not required to inform the patient of any alternative therapies.
• D. None of the above.

Correct answer: A

Rationale: The correct answer is preparing the patient to give informed consent. Giving informed consent is the process of providing a patient with all necessary information about a medical procedure, including how it's done, what to expect, the likelihood of success, and potential risks and side effects. This allows the patient to make an informed decision about their treatment. Protecting HIPAA (Health Insurance Portability and Accountability Act) involves safeguarding patient health information and is not directly related to the scenario described. It is important for physicians to inform patients of any alternative therapies available to them to ensure they have all relevant information to make a decision regarding their treatment. Therefore, choice C, 'Not required to inform the patient of any alternative therapies,' is incorrect. Choice D, 'None of the above,' is incorrect as the physician is indeed preparing the patient for informed consent.

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