Nursing Elites

1. A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first?

• A. Remove the restraints from the client's wrists
• B. Review the chart for nonrestraint alternatives for agitation
• C. Speak with the AP about the incident
• D. Inform the unit manager of the incident

Correct answer: A

Rationale: The correct action for the nurse to take first is to remove the restraints from the client's wrists. Restraints should not be applied without a prescription due to the risk of harm to the client. Removing the restraints promptly is a priority to ensure the client's safety. Reviewing nonrestraint alternatives, speaking with the AP, and informing the unit manager can follow after ensuring the client's immediate safety by removing the restraints.

2. Your patient has been diagnosed with giant cell arthritis. What medication will this patient most likely be given?

• A. High doses of aspirin
• B. High doses of prednisone
• C. Methotrexate
• D. Albuterol

Correct answer: B

Rationale: High doses of prednisone are commonly prescribed for giant cell arthritis to reduce inflammation. Aspirin is not typically used for this condition. Methotrexate is more commonly used for conditions like rheumatoid arthritis, not giant cell arthritis. Albuterol is a bronchodilator used for respiratory conditions, not for giant cell arthritis.

3. Which of the following is something a new model for health care in the future should include?

• A. Community-centered care
• B. Care that encourages a healthy environment
• C. Accessible care that is affordable for most
• D. A focus on local health concerns

Correct answer: B

Rationale: The correct answer is B because a new model for health care in the future should focus on promoting a healthy environment. This includes initiatives such as green buildings and reducing pollution to improve overall health outcomes. Choice A, community-centered care, is important but not the primary focus when considering the future of healthcare. Choice C, accessible and affordable care, is crucial but does not directly address the need for a healthy environment. Choice D, a focus on local health concerns, is relevant but not as comprehensive as promoting a healthy environment in shaping the future of healthcare.

4. A healthcare provider is caring for a client who has anorexia nervosa. Which of the following interdisciplinary team members should be consulted in regards to client care?

• A. Occupational therapist
• B. Case manager
• C. Nutritionist
• D. Psychiatrist

Correct answer: B

Rationale: A case manager is the most appropriate interdisciplinary team member to consult for a client with anorexia nervosa. They can help coordinate care, resources, and communication between various healthcare professionals involved in the client's treatment. Consulting an occupational therapist (Choice A) may not directly address the primary concerns associated with anorexia nervosa. While nutritional therapists (Choice C) play a role in addressing nutritional needs, a case manager is better suited for overall care coordination. Mental health counselors (Choice D) focus more on emotional and psychological aspects, whereas a case manager coordinates practical aspects of care.

5. Which preventive measure can be employed to decrease the risk of compartment syndrome?

• A. The administration of a potassium-sparing diuretic for heart failure
• B. A bivalve cast for a skeletal fracture
• C. A cerebral diuretic to decrease intracranial pressure after a head injury
• D. A chest tube to restore normal intrathoracic pressure after a pneumothorax

Correct answer: B

Rationale: The correct answer is B. A bivalve cast can help decrease the risk of compartment syndrome by providing space for swelling, thus preventing the build-up of pressure within the muscles. Choices A, C, and D are incorrect because they are not directly related to preventing compartment syndrome. Choice A is more focused on managing heart failure, choice C on reducing intracranial pressure, and choice D on restoring intrathoracic pressure after a pneumothorax, which are not relevant to preventing compartment syndrome.

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