Nursing Elites

1. Why might the physician order antibiotics to be given through the central venous access device (CVAD) rather than through a peripheral IV line if the CVAD becomes infected?

• A. To prevent infiltration of the peripheral line
• B. To reduce the pain and discomfort associated with antibiotic administration in a small vein
• C. To lessen the chance of an allergic reaction to the antibiotic
• D. To attempt to eliminate microorganisms in the catheter and prevent having to remove it

Correct answer: D

Rationale: When a patient's central venous access device (CVAD) becomes infected, administering antibiotics through the line is essential to attempt to eliminate microorganisms within the catheter. The goal is to prevent the necessity of removing the catheter, which might be required if the infection persists. Choice A, 'To prevent infiltration of the peripheral line,' is incorrect as the priority is addressing the catheter infection, not preventing issues with a peripheral line. Choice B, 'To reduce the pain and discomfort associated with antibiotic administration in a small vein,' is not relevant to the rationale for choosing the CVAD for antibiotic administration. Choice C, 'To lessen the chance of an allergic reaction to the antibiotic,' is also incorrect as the main focus is managing the catheter-associated infection rather than allergy prevention.

2. When a woman is having her first child, she is experiencing which type of crisis event?

• A. situational
• B. maturational
• C. adventitious
• D. reactive

Correct answer: B

Rationale: A maturational crisis occurs when an individual reaches a new stage of development, such as becoming a parent for the first time, and needs to develop new coping strategies to adapt to this change. Situational crises (Choice A) arise from external sources, not developmental milestones. Adventitious crises (Choice C) are caused by external events like natural disasters and are not related to personal development stages. Reactive crises (Choice D) are responses to specific stressors and are not associated with developmental milestones like becoming a parent for the first time.

3. A client with acute leukemia develops a low white blood cell count. In addition to the institution of isolation, the nurse should:

• A. Request that foods be provided in sealed single-serving packages
• B. Ask the client to wear a mask when visitors are present
• C. Prep IV sites with mild soap and water and alcohol
• D. Provide foods in sealed single-serving packages

Correct answer: D

Rationale: For a client with acute leukemia and a low white blood cell count, preventing exposure to food contaminants is crucial due to immune suppression. Providing foods in sealed single-serving packages helps reduce the risk of contamination. Choice B is incorrect as it introduces the potential of infection from visitors. Choice A, suggesting disposable utensils, is not as effective as sealed containers in preventing food contamination. Choice C, using alcohol for prepping IV sites, is less suitable due to its drying effect and potential for skin breakdown, making sealed packages a better option for food safety.

4. What is a common characteristic of a batterer?

• A. Grew up in a loving, secure home
• B. Was an only child
• C. Was physically or psychologically abused
• D. Admits they have a problem with anger

Correct answer: C

Rationale: The correct answer is that a batterer is typically someone who was physically or psychologically abused. Research shows that many individuals who engage in abusive behavior report a history of being abused themselves. Choices A, B, and D are incorrect. While it is possible for a batterer to have grown up in a loving, secure home, been an only child, or acknowledge their anger issues, the most common factor associated with becoming a batterer is a history of being abused.

5. When providing culturally competent care to a couple from the Philippines living in the United States who are expecting their first child, what should the nurse do first?

• A. review their own cultural beliefs and biases
• B. respectfully request that the couple only use medically approved health care providers
• C. understand the clients' need to learn the accepted medical practices of their new country
• D. study family dynamics to comprehend the male and female gender roles in the clients' culture

Correct answer: A

Rationale: When providing culturally competent care, the nurse's initial step is to reflect on and understand their own cultural beliefs and biases. By doing so, the nurse can approach the care of the couple from the Philippines with sensitivity and respect. This self-awareness helps the nurse recognize potential differences in beliefs and values, fostering effective communication and care. Option B is incorrect because it does not address the nurse's need for self-reflection. Option C is incorrect as it focuses on the clients adapting to the new country's practices rather than the nurse understanding the clients' existing beliefs. Option D is incorrect as it pertains to family dynamics and gender roles rather than the nurse's self-awareness.

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