Nursing Elites

1. When escorting a patient to the operating room on a stretcher, what should you do to prevent the patient from falling?

• A. Ensure the safety belt or strap is secured on the patient while escorting them to the operating room
• B. Use a safety belt or strap on the patient throughout their escort to the operating room
• C. Lower the bed position when moving the patient from the bed to the stretcher
• D. All of the above options are correct

Correct answer: B

Rationale: When escorting a patient to the operating room on a stretcher, it is crucial to secure a safety belt or strap on the patient to prevent falls during the transfer. This safety measure is not considered a restraint but a necessary precaution. Lowering the bed position is not necessary; in fact, the bed should be in a high position to align with the stretcher. Locking the wheels of the stretcher is essential to prevent accidents during patient transfer. Therefore, the correct action to prevent falls while moving a patient to the operating room is to use a safety belt or strap on the patient throughout the escort.

2. A client with hyperkalemia may exhibit peaked T waves on an electrocardiogram. This manifestation is an early sign of high potassium levels, but the diagnosis should not be based on this aspect alone. Untreated, hyperkalemia can lead to progressively worsening cardiac instability.

• A. A lumbar puncture takes a sample of cerebrospinal fluid from the back, which will be analyzed by the lab.
• B. The physician will insert a needle at the level of L4-L5 in the spinal cord.
• C. The client should lie flat on their back for a specific period following the procedure.
• D. The risks of the procedure include headache, back pain, and infection.

Correct answer: B

Rationale: A lumbar puncture is performed to obtain cerebrospinal fluid for analysis to investigate various conditions affecting the client. During the procedure, the client is typically positioned on their side or sitting leaning over a table with their back rounded. The physician inserts a needle into the back around the L4-L5 vertebrae to collect the sample. Option A is incorrect because a lumbar puncture does not draw blood but instead collects cerebrospinal fluid. Option C is incorrect as the client should not necessarily lie flat for 24 hours post-procedure. Option D is incorrect as the common risks of a lumbar puncture include headache, back pain, and potential infection, not nausea, rash, or hypotension.

3. A systemic sign of infection is ______________.

• A. swelling
• B. redness
• C. heat
• D. a lack of appetite

Correct answer: D

Rationale: The correct answer is 'a lack of appetite.' When a person experiences a systemic infection, they may exhibit signs that affect the entire body. A lack of appetite is a common systemic sign of infection, along with other symptoms like rapid pulse, fever, and an elevated white blood cell count. Swelling, redness, and heat are more indicative of localized inflammation or infection, rather than systemic involvement.

4. A new nursing unit is opening in the hospital. In order to meet the staffing needs of the unit, nurses from other areas will be moved and required to work in the new area. When notifying the nurses chosen to staff this area, the nurse manager states, 'You will either move to work on this unit or you will no longer be employed at this hospital.' Which of the following strategies is this nurse manager using?

• A. Manipulation
• B. Facilitation
• C. Co-optation
• D. Coercion

Correct answer: D

Rationale: The nurse manager in this scenario is using a coercion tactic to influence the nurses' job changes. Coercion involves using power to force others to make a choice. In this case, the nurses are left with no option but to either work on the new unit or face termination. Choice A, 'Manipulation,' is incorrect as manipulation involves influencing others through deceit or dishonesty, which is not evident in this situation. Choice B, 'Facilitation,' is incorrect as it refers to the process of making something easier or more convenient, which is not applicable here. Choice C, 'Co-optation,' involves absorbing or integrating individuals into a group, which does not align with the scenario described. Therefore, the most suitable term for the nurse manager's strategy is 'Coercion.'

5. A nurse is caring for a dying client whose family wants to be with him in the operating suite. The surgeon, however, does not allow families to be present during surgery. The nurse recognizes this as an ethical dilemma. What is the initial step of the nurse when managing this situation?

• A. Contact the physician to amend the order for the client
• B. Document an account of the situation to ensure adequate coverage of details
• C. Consult with the medical ethics committee to determine a safe and workable solution
• D. Speak with the chief nursing officer to change the policy governing this situation

Correct answer: A

Rationale: In this type of situation, the first action of the nurse should be to address the immediate needs of the client by requesting the physician to make a change based on the circumstances. The primary concern is to ensure the client's well-being and honor the family's wishes, even if it means deviating from standard protocols. While documentation (Choice B) and consulting with higher authorities like the medical ethics committee (Choice C) may be necessary at a later stage, the initial step is to take action to meet the client's needs promptly. Speaking with the chief nursing officer to change the policy (Choice D) is not the most immediate or practical step in this situation, as the focus should be on the client's current care needs.

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