Nursing Elites

1. A nurse in the emergency department is assessing a client who is unconscious following a motor-vehicle crash. The client requires immediate surgery. Which of the following actions should the nurse take?

• A. Transport the client to the operating room without verifying informed consent
• B. Ask the anesthesiologist to sign the consent
• C. Obtain telephone consent from the facility administrator before the surgery
• D. Delay the surgery until the nurse can obtain informed consent

Correct answer: A

Rationale: In emergency situations where a client is unconscious and requires immediate surgery, implied consent applies. Implied consent allows healthcare providers, including nurses, to proceed with necessary treatment or surgery without formally verifying informed consent. Choice A is correct because the priority in this scenario is to ensure the client receives timely medical intervention to address life-threatening conditions. Choices B, C, and D are incorrect because in emergencies, waiting to obtain formal consent can delay critical treatment, risking the client's health and well-being.

2. A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the following actions should the nurse take first?

• A. Discuss time management strategies with the nurses
• B. Provide coverage for the nurses' breaks
• C. Determine the reasons the nurses are not taking scheduled breaks
• D. Review policies for taking scheduled breaks

Correct answer: C

Rationale: The correct answer is to determine the reasons the nurses are not taking scheduled breaks. This action is crucial as it allows the charge nurse to understand the underlying causes for the behavior. By identifying the reasons, the nurse can then address the root of the issue effectively. Option A is incorrect because discussing time management strategies may not address the specific reasons for not taking breaks. Option B is incorrect as providing coverage for breaks does not address the underlying cause of the issue. Option D is also incorrect as reviewing policies should come after understanding the reasons for the behavior.

3. Which skin disorder most closely resembles and mimics dandruff?

• A. Lice infestation
• B. Scabies
• C. Dermatitis
• D. Acne vulgaris

Correct answer: C

Rationale: Dermatitis can closely resemble and mimic dandruff due to similar symptoms like flaking and itching. Lice infestation (choice A) is characterized by the presence of lice and their eggs attached to the hair shaft, different from dandruff. Scabies (choice B) is a contagious skin condition caused by mites, presenting as burrows, rashes, and intense itching, not typically resembling dandruff. Acne vulgaris (choice D) is a skin condition involving hair follicles and sebaceous glands, manifesting as pimples and inflammation, which is distinct from dandruff.

4. Nurses on an inpatient care unit are working to help reduce unit costs. Which of the following actions is appropriate to include in the cost-containment plan?

• A. Store opened bottles of normal saline in a refrigerator for up to 48 hours.
• B. Return unused supplies from the bedside to the unit's supply stock.
• C. Wait to dispose of sharps containers until they are completely full.
• D. Use clean gloves rather than sterile gloves for colostomy care.

Correct answer: D

Rationale: Using clean gloves rather than sterile gloves for colostomy care is a cost-effective measure without compromising care quality. This choice helps in reducing costs without compromising patient safety. Storing opened bottles of normal saline in a refrigerator for up to 48 hours (Choice A) may lead to contamination risks. Returning unused supplies to the unit's supply stock (Choice B) can be inefficient and lead to potential waste. Waiting to dispose of sharps containers until they are completely full (Choice C) may pose safety hazards and not directly impact cost savings.

5. The wound irrigation process cleanses the wound and:

• A. Reduces the potential pain in the wound region or area.
• B. Stops the spread of infection by creating a 'clean' area.
• C. Pushes extravasated blood from a hematoma into nearby healthy tissue.
• D. Allows for the introduction of medications in solution form.

Correct answer: D

Rationale: The correct answer is D because wound irrigation allows for the introduction of medications in solution form to the wound site. Choice A is incorrect because while wound irrigation can help with pain management indirectly by promoting healing, its primary purpose is not to reduce pain directly. Choice B is incorrect as wound irrigation primarily aims to cleanse the wound and remove contaminants rather than creating a 'clean' area to stop infection spread. Choice C is incorrect because wound irrigation does not involve pushing extravasated blood from a hematoma into nearby healthy tissue; its main goal is to cleanse the wound and promote healing.

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