Nursing Elites

1. Your long-term care patient has chronic pain and at this point in time, the patient needs increasing dosages to adequately control this pain. What is this patient most likely affected by?

• A. Drug addiction
• B. Drug interactions
• C. Drug side effects
• D. Drug tolerance

Correct answer: D

Rationale: The correct answer is D: Drug tolerance. When a patient needs increasing dosages to achieve the same pain relief, it indicates the development of drug tolerance. This means the body has adapted to the drug, requiring higher doses to produce the same effect. Choice A, drug addiction, is incorrect because drug addiction involves a psychological and physical dependence on the drug, which is not described in the scenario. Choice B, drug interactions, is incorrect as it refers to the effects when multiple drugs interact with each other, not the situation described. Choice C, drug side effects, is also incorrect as it pertains to the unintended effects of a drug, not the need for higher doses to control pain.

2. Select the tactile sensation that is accurately paired with its description or procedure for testing.

• A. Fine motor coordination: The use of the fingers
• B. Stereognosis: Equal hearing in both ears
• C. Two-point discrimination: The nurse gently pricks the patient's skin
• D. Gross motor function: The use of the lower limbs

Correct answer: C

Rationale: The correct answer is C: Two-point discrimination: The nurse gently pricks the patient's skin. Two-point discrimination assesses the ability to discern two points touched simultaneously on the skin. Fine motor coordination (Choice A) refers to the precise movements of small muscles, not related to tactile sensation. Stereognosis (Choice B) is the ability to recognize objects by touch, not equal hearing in both ears. Gross motor function (Choice D) involves the coordination of large muscle groups, not specifically related to tactile sensation testing.

3. Which technique or method is used to determine whether or not the patient has an irregular pulse?

• A. Apical pulse
• B. Inspection
• C. Auscultation
• D. Percussion

Correct answer: A

Rationale: An apical pulse check is used to determine if the patient has an irregular pulse. The apical pulse is located at the point of maximal impulse (PMI) and is assessed using a stethoscope. Choice B, inspection, involves visual examination and is not used to assess pulse irregularities. Choice C, auscultation, involves listening to internal sounds using a stethoscope, which can be used to assess heart sounds but not specifically for pulse irregularities. Choice D, percussion, is a technique used to assess the density of body tissues or detect abnormal masses and is not used to determine pulse irregularities.

4. What is the main purpose of quality improvement in healthcare?

• A. To increase healthcare costs
• B. To improve patient outcomes
• C. To decrease patient satisfaction
• D. To increase hospital stays

Correct answer: B

Rationale: The main purpose of quality improvement in healthcare is to improve patient outcomes by enhancing the quality and safety of healthcare services. Choice A is incorrect because the goal is not to increase healthcare costs but to optimize resources and provide cost-effective care. Choice C is incorrect as the aim is to increase patient satisfaction through better outcomes. Choice D is incorrect as the objective is to reduce hospital stays by improving care efficiency and effectiveness.

5. A nurse in the emergency department is performing triage for a group of clients who were in a train crash. Which of the following clients should the nurse tag as emergent?

• A. A client who has an open fracture of the femur
• B. A client who has periorbital ecchymosis
• C. A client who has asymmetrical thorax
• D. A client who has a deep-partial thickness burn on the lower extremities

Correct answer: C

Rationale: In a triage situation, an asymmetrical thorax suggests a potentially life-threatening condition such as a pneumothorax or hemothorax, requiring immediate attention. This client should be tagged as emergent. Periorbital ecchymosis and deep-partial thickness burns, while concerning, may not indicate an immediate life-threatening situation. An open fracture of the femur, although serious, can be prioritized after addressing emergent cases.

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