Nursing Elites

1. A complication of osteoporosis is _______________?

• A. rheumatoid arthritis
• B. gouty arthritis
• C. dorsiflexion
• D. joint deformity

Correct answer: D

Rationale: Joint deformity is a well-known complication of osteoporosis, leading to structural changes in the joints due to bone loss and fragility. Gouty arthritis and rheumatoid arthritis are distinct types of arthritis that are not direct complications of osteoporosis. Dorsiflexion is a movement related to the foot's range of motion and is not a typical complication of osteoporosis.

2. What does the 'B' in the SBAR acronym stand for?

• A. Background
• B. Basic
• C. Beginning
• D. Break

Correct answer: A

Rationale: The 'B' in the SBAR acronym stands for Background. SBAR is a standardized communication tool used in healthcare to effectively communicate critical information. In this context, 'Background' refers to providing relevant information about the patient's history, current status, and any other pertinent details. This information helps ensure clear and concise communication between healthcare providers, enhancing patient care. Choice B, 'Basic,' is incorrect as the 'B' specifically emphasizes the detailed background information. Choices C and D, 'Beginning' and 'Break,' are not accurate in the context of the SBAR communication tool.

3. Who among the following individuals wrote a medical code of ethics?

• A. Hammurabi
• B. Thomas Percival
• C. Hippocrates
• D. All of the above

Correct answer: D

Rationale: All of the above individuals contributed to the development of medical ethics. Hammurabi created the earliest known code around 2500 BC. Hippocrates, known for the principle 'Do no harm,' emphasized ethical practices in medicine. Thomas Percival, a physician interested in sociological medicine, authored a Code of Medical Ethics in 1803, which influenced modern medical ethics. Therefore, the correct answer is 'All of the above.' Choices A, B, and C are incorrect because each of them individually wrote a medical code of ethics, making 'All of the above' the most inclusive and accurate answer.

4. All hospitals and nursing homes are mandated to have the goal of a restraint-free environment. The best way to achieve this goal is to ________________.

• A. ban the use of all restraints under all circumstances
• B. limit restraints to only those situations when falls cannot be prevented
• C. keep all bedside rails up for all patients during nighttime hours
• D. use non-skid socks and sheets to prevent falls from chairs

Correct answer: B

Rationale: All hospitals and nursing homes are mandated by JCAHO and state departments of health to have the goal of a restraint-free environment. This does not mean that no restraints can ever be used under any circumstances. The goal is to minimize the use of restraints and prioritize other preventive measures. Restraining a patient should only be considered when all other preventive strategies have failed, and the patient is at risk of harm. Therefore, the best approach is to limit the use of restraints to situations where falls cannot be prevented, ensuring that restraints are used as a last resort to maintain patient safety. Choices C and D are not ideal solutions as they do not address the appropriate use of restraints in a restraint-free environment.

5. Which method is most appropriate for managing moral distress in the workplace?

• A. Recognizing that life is unfair and nurses cannot meet every need of every client
• B. Declining to act when clients or visitors make requests that are not justifiable
• C. Developing a new policy that would address the problematic situation
• D. Both A and B

Correct answer: C

Rationale: Moral distress involves negative feelings or frustration toward situations that are deemed unfair, unethical, or that cause the nurse to feel helpless in their work. It can lead to nurse burnout when ongoing issues are not resolved. The most appropriate method for managing moral distress is to develop new policies that address the problematic situations. By creating policies, nurses can work towards changing current standards and reducing the number of situations that lead to moral distress. Choices A and B are incorrect because recognizing life's unfairness and not taking action on unjustifiable requests do not actively address the root causes of moral distress or work towards resolving the issues.

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