Nursing Elites

1. An occupational health nurse works at a manufacturing plant where there is potential exposure to inhaled dust. Which action, if recommended by the nurse, will be most helpful in reducing the incidence of lung disease?

• A. Treat workers with pulmonary fibrosis.
• B. Teach about symptoms of lung disease.
• C. Require the use of protective equipment.
• D. Monitor workers for coughing and wheezing.

Correct answer: C

Rationale: Prevention of lung disease requires the use of appropriate protective equipment such as masks to reduce exposure to inhaled dust, which is a significant risk factor for lung disease. Teaching about symptoms of lung disease, treating workers with pulmonary fibrosis, and monitoring for coughing and wheezing are important actions for early recognition and treatment of lung disease. However, the most effective strategy to prevent lung damage in this scenario is to require the use of protective equipment to minimize exposure to harmful substances.

2. Choose the BEST answer. To ensure adequate protection for legal issues, offices should maintain patients' charts for:

• A. 10 years
• B. Forever
• C. Until the age of majority
• D. 2 years after the patient was last seen in the office

Correct answer: B

Rationale: The correct answer is 'Forever.' Maintaining patients' charts indefinitely ensures comprehensive legal protection by having all relevant information available in case of litigation or if patient history needs to be referenced in the future. Choice A, '10 years,' may not be sufficient to cover the entire period within which legal issues may arise. Choice C, 'Until the age of majority,' is not ideal as legal matters may extend beyond this age limit. Choice D, '2 years after the patient was last seen in the office,' is inadequate as legal actions can occur beyond this timeframe, necessitating the need for long-term retention of patient charts.

3. Which of the following is an example of the intervention phase of the individualized nursing care plan for a client who receives a colostomy after a bowel resection?

• A. Taking a health history and performing a physical exam prior to the procedure
• B. Instructing the client about how to care for his colostomy stoma
• C. Developing goals that state the client will ambulate three times a day
• D. Determining that the client may need more support at home after dismissal

Correct answer: B

Rationale: The intervention stage of the individualized nursing care plan is where the nurse provides care, treatments, or education to help the client meet the devised outcomes. Instructing the client about how to care for his colostomy stoma is the correct example of an intervention as it directly involves providing education and guidance to the client on post-operative care. This intervention supports the process of helping the client meet the outcomes designed for this case, which is to enable the client to properly care for his colostomy after a bowel resection. The other options do not directly involve interventions aimed at assisting the client in meeting the specific care needs related to the colostomy procedure.

4. Which action represents the evaluation stage of the plan of care?

• A. The nurse assigns a nursing diagnosis of Impaired Skin Integrity related to diminished skin circulation
• B. The nurse assesses the client's vital signs and asks about symptoms
• C. The nurse determines that the client is not meeting his set outcomes and makes revisions
• D. The nurse discusses the client's health history

Correct answer: C

Rationale: The correct answer is C. The evaluation stage of the nursing process involves reviewing the assessments, diagnoses, and interventions given to the client and then determining if the client is meeting expected outcomes. In this scenario, the nurse is assessing whether the client is meeting the outcomes set for their care plan and making revisions as needed. Choice A is incorrect as assigning a nursing diagnosis is part of the nursing diagnosis phase, not the evaluation phase. Choice B represents the assessment phase of the nursing process, not the evaluation phase. Choice D involves discussing the client's health history, which is more aligned with the assessment phase rather than the evaluation phase.

5. A healthcare professional is preparing to draw a blood specimen from an adult client's central line. All of the following actions for this procedure are correct EXCEPT:

• A. Disconnect the current infusion
• B. Clean the cap with alcohol and attach a 5 cc syringe
• C. Draw 5 cc of a blood sample to discard
• D. Flush with saline after the sample

Correct answer: B

Rationale: When drawing a blood specimen from a central line, the healthcare professional should disconnect any infusions that are currently running and that could contaminate the specimen. It is important to use a minimum size of a 10 cc syringe when using a central line to avoid placing too much pressure on the catheter. Cleaning the cap with alcohol and attaching a 5 cc syringe is not appropriate as a larger syringe size should be used for this procedure. Drawing 5 cc of a blood sample to discard and flushing with saline after the sample are correct steps in the process of drawing a blood specimen from a central line.

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