Nursing Elites

1. 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.

2. Which of the following is the best way for a nurse to improve quality of care?

• A. Recognize that physicians are among the health-care professionals interested in improving quality of care.
• B. Work with patients and families to improve healthcare.
• C. Collaborate with other health-care professionals, patients, and their families.
• D. Recognize that physicians are among the numerous professionals in health care.

Correct answer: C

Rationale: The best way for a nurse to improve the quality of care is by collaborating with other health-care professionals, patients, and their families. By working together with the healthcare team, patients, and families, nurses can ensure a holistic approach to care delivery, leading to better outcomes. Choices A and D are incorrect as they focus solely on physicians, while choice B, though important, does not fully encompass the collaborative aspect necessary for comprehensive care.

3. A nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.4 mEq/L. Which of the following would the nurse expect to note on the electrocardiogram as a result of the laboratory value?

• A. ST depression
• B. Inverted T wave
• C. Prominent U wave
• D. Tall peaked T waves

Correct answer: D

Rationale: The correct answer is 'Tall peaked T waves.' Tall peaked T waves are characteristic ECG changes associated with hyperkalemia. In hyperkalemia, the elevated potassium levels affect the myocardium, leading to changes in the ECG. ST depression (Choice A) is more commonly associated with myocardial ischemia or infarction. Inverted T wave (Choice B) is seen in conditions like myocardial ischemia or CNS events. Prominent U wave (Choice C) is typically associated with hypokalemia or certain medications. Therefore, in this scenario, the nurse would expect to note tall peaked T waves on the electrocardiogram due to the elevated potassium level.

4. Which nonpharmacological technique involves the use of electronic monitoring equipment while the patient controls basic bodily mechanisms?

• A. Meditation
• B. Visualization
• C. Biofeedback
• D. Chiropractic

Correct answer: C

Rationale: The correct answer is C: Biofeedback. Biofeedback is a nonpharmacological technique that uses electronic monitoring equipment to provide real-time data on physiological processes such as heart rate, muscle tension, and skin temperature. Through this feedback, patients learn to control and regulate these bodily functions voluntarily. Choice A, Meditation, involves focusing the mind and reducing stress through techniques like mindfulness or deep breathing, but it does not specifically rely on electronic monitoring equipment. Choice B, Visualization, is a technique where individuals imagine peaceful scenes to promote relaxation and reduce anxiety, and it also does not involve electronic monitoring. Choice D, Chiropractic, is a healthcare profession that focuses on the diagnosis and treatment of musculoskeletal disorders through manual adjustments and manipulation, which is unrelated to the use of electronic monitoring equipment for controlling bodily functions.

5. Which of the following strategies can help reduce healthcare-associated infections?

• A. Using outdated medical equipment
• B. Implementing strict hygiene protocols
• C. Increasing patient wait times
• D. Reducing nursing staff

Correct answer: B

Rationale: Correct Answer: Implementing strict hygiene protocols can help reduce healthcare-associated infections. By maintaining high standards of hygiene, such as proper handwashing, sterilization of equipment, and cleanliness of the environment, the spread of infections can be minimized. Choices A, C, and D are incorrect. Using outdated medical equipment can increase the risk of infections due to lack of proper maintenance and sterilization. Increasing patient wait times may lead to frustration but does not directly impact infection rates. Reducing nursing staff can compromise patient care and monitoring but is not specifically related to reducing healthcare-associated infections.

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